Onur Yilmaz
Canakkale Onsekiz Mart University, Turkey, TurkeyTitle: No decrease in infection rate with the use of local vancomycin powder after partial hip replacement in elderly patients with comorbidities
Abstract
Introduction: The goal of this study was to evaluate the effects of
local intra-wound vancomycin powder (VP) administration to decrease surgical
site infections (SSIs), particularly in elderly patients with comorbidities,
after having undergone partial hip replacement in the treatment of
intertrochanteric (ITF) or femoral neck fractures (FNF).
Methods: We retrospectively reviewed patients who underwent partial
hip replacement in the treatment of ITF or FNF in one year. We divided the
patients into two groups. The non vancomycin-treated group received standard
systemic prophylaxis only (1 gr cefazolin IV), while the vancomycin-treated
group received 1 gr of VP in the surgical wound just before surgical closure in
addition to the systemic prophylaxis. We included patients of 64 years or older
who also had one or more comorbidities. We compared the post-operative SSI
rates between the non vancomycin-treated group and the vancomycin-treated
group.
Results: A total of 93 patients were included in the study. We
detected post-operative wound infection in six patients (6.4%). The rate of SSI
was found to be 5.7% in the vancomycin-treated group and 6.9% in the non
vancomycin-treated group respectively, which showed no statistically
significant difference (p:0.498). The incidence of SSI was statistically higher
in the patients who had a follow-up in the post-operative intensive care unit
than the patients who had not any follow-up in the intensive care unit.
Conclusion: Local application of VP in the surgical wound was found
to be ineffective in reducing the incidence of SSI after partial hip replacement
in elderly patients with comorbidities.
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