Effect of intra‐wound vancomycin on the surgical site wound infection after spinal surgery: A meta‐analysis

Abstract

The topical application of the vancomycin in spine surgery is an effective method of reducing the incidence of postsurgical infections. However, there are differences in the prophylactic strategies used for various spinal surgeries. Therefore, the primary aim of this meta-analysis was to evaluate the effectiveness of the application of the intra-wound vancomycin during spine surgery. For this purpose, 100 studies were identified through different databases and search engines with various search terms such as ‘intrawound vancomycin in surgery’, ‘intrawound applications of vancomycin’, ‘vancomycin in surgery’, ‘intraoperative vancomycin’, ‘vancomycin spinal surgeries’, ‘treating surgical site infections in spinal surgeries using vancomycin’, ‘spinal surgery’, ‘vancomycin in spinal surgery’, ‘spine surgery’, ‘topical vancomycin’ and ‘local vancomycin’. Furthermore, the identified studies were reviewed thoroughly and finally, 19 studies were selected for meta-analysis. The selected studies were included based on the inclusion criteria and data was extracted from the selected studies. The pool of the statistically significant studies was further analysed using the ‘meta’ package of R version 4.3.2. The analysed data resulted in statistically significant results with a p-value <0.001 and the heterogeneity at 50% suggesting that the meta-analysis results may be significant in supporting the application of vancomycin at surgical sites to reduce the surgical site infections and eventually improve the postoperative conditions by reducing the long hospital stays.