Prophylactic Use of Vancomycin and Pre-operative Irrigation of Surgical Field are Effective Preventive Measures for Methicillin-resistant Staphylococcus-induced Surgical Site Infections after Spinal Surgery

Abstract

Surgical site infection (SSI) is a devastating complication in spinal surgery. However, preventive measures have yet to be established. Two-hundred and eighty-six patients who underwent spinal surgery in our department between June 2009 and September 2010 were followed prospectively. They underwent preventive measures such as: prophylactic antibiotics for two to three days, irrigation of the surgical site just before surgery and prophylactic administration of vancomycin if the patients had several risk related factors of methicillin-resistant Staphylococcus (MRS) infection. The risk related factors of MRS infection are administration via emergency ward, spinal instrumentation and skin lesion such as atopic dermatitis. The incidence of SSI during this period was compared with previous period between May 2005 and April 2009.
SSI occurred in nine patients out of 286 patients (3.1%) during this period, and in 21 out of 795 patients (2.6%) during the previous period. There were no statistically differeuces between the two periods for SSI incident rate. Although the rate of SSI did not decrease, the incidence of SSI by MRS decreased. These results suggest that prophylactic use of vancomycin for some cases and irrigation of the surgical site just before surgery are effective preventive measures for MRS-induced SSI after spinal surgery.