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Vancomycin powder

Jessica Bear, Natalie Rollick, David Helfet
PURPOSE OF REVIEW: Tibial plafond, or pilon, fractures can be some of the most difficult fractures to manage. As they are often associated with high-energy trauma, both the soft tissue involvement and the comminuted fracture pattern pose challenges to fixation. Furthermore, the complex anatomy and trauma to the cartilage at the time of injury predispose pilon fractures to poor functional outcomes and high rates of posttraumatic arthritis. This review will discuss the recent developments in the treatment of tibial pilon fractures...
October 20, 2018: Current Reviews in Musculoskeletal Medicine
Stefanie M Shiels, David J Tennent, Alicia L Lofgren, Joseph C Wenke
Infectious complications can reduce fracture healing rate. Broad spectrum antibiotics are commonly administered to prevent and treat musculoskeletal infections. Local antibiotics are applied to the wound site to increase therapeutic concentrations without increasing systemic toxicity however may hinder local tissue recovery. Rifampin has been shown to eradicate mature Staphylococcal biofilms and its use proven for treating musculoskeletal infections. In this study, a spontaneously healing defect model in a rat was used to investigate the impact rifampin powder has on endogenous bone healing in both a sterile and contaminated wound...
October 1, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Cyrus Caroom, Dustin Moore, Nithya Mudaliar, Craig Winkler, Jefferson Murphree, Ian Ratheal, Michael Fry, Mark Jenkins, Jessica Tullar, Abdul Hamood
OBJECTIVES: To compare the effectiveness of both vancomycin powder and antibiotic bead placement to irrigation and debridement alone in prevention of infection in a contaminated open fracture model in rats. METHODS: In a previously described model of contaminated open fractures, 45 rats had simulated open fractures created, stabilized, and contaminated with Staphylococcus aureus. They were then treated 6 hours later with 3 interventions: irrigation and debridement alone (control group) or in combination with placement of polymethyl methacrylate beads containing vancomycin and tobramycin powders (antibiotic bead group) or placement of 10 mg of intrawound vancomycin powder (powder group)...
October 2018: Journal of Orthopaedic Trauma
Fred A Sweet, Craig W Forsthoefel, Andrea R Sweet, Ryan K Dahlberg
BACKGROUND: The purpose of this study was to compare the local application of a variety of antimicrobial agents with intravenous (IV) antibiotics for infection prophylaxis in a rat model. METHODS: A total of 120 adult male Sprague-Dawley rats were implanted with an expanded polytetrafluoroethylene (ePTFE) vascular graft in a submuscular position and challenged with 2 × 10 colony-forming units of methicillin-sensitive Staphylococcus aureus (MSSA). Twenty rats received pretreatment with IV cefazolin and 20 rats were pretreated with IV vancomycin...
September 19, 2018: Journal of Bone and Joint Surgery. American Volume
Mikinobu Takeuchi, Norimitsu Wakao, Mitsuhiro Kamiya, Atsuhiko Hirasawa, Kenta Murotani, Masakazu Takayasu
OBJECTIVE Retrospective studies have reported that the local application of vancomycin (VCM) powder into the operative field decreases the incidence of surgical site infection (SSI) in thoracic and/or lumbar fusion. Authors of the present study prospectively evaluated the effects of VCM in patients undergoing thoracic and/or lumbar fusion. METHODS In this randomized double-blind trial, 230 patients undergoing thoracic and/or lumbar fusion were randomly assigned to the local administration of VCM (interventional group, 1 g) or ampicillin (AMP; control group, 1 g) into the surgical field...
August 10, 2018: Journal of Neurosurgery. Spine
Ena Nielsen, Lindsay M Andras, Liam R Harris, David L Skaggs
INTRODUCTION: The aim of this study was to investigate whether preoperative methicillin-resistant Staphylococcus aureus (MRSA) swab results were predictive of surgical site infections (SSIs) in pediatric patients who have undergone spinal fusion. METHODS: We conducted a retrospective chart review of patients who underwent posterior spinal fusion between 2004 and 2014 to determine preoperative MRSA colonization status and SSI rates and organisms. Before October 1, 2012, we administered vancomycin to the patients for infection prophylaxis; beginning October 1, 2012, patients received ceftazidime and Ancef (cefazolin for injection; GlaxoSmithKline)...
September 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
A Sharipova, S K Swain, I Gotman, D Starosvetsky, S G Psakhie, R Unger, E Y Gutmanas
An original fabrication route of high-strength bulk Fe-5Ag and Fe-10Ag nanocomposites with enhanced degradation rate is reported. Near fully dense materials with fine nanostructures and uniform distribution of Ag nanoparticles were obtained employing high energy attrition milling of Fe-Ag2 O powder blends followed by cold sintering - high pressure consolidation at ambient temperature that allowed the retention of the nanoscale structure. Annealing in hydrogen flow at 550 °C resulted in enhanced ductility without coarsening the nanostructure...
October 2018: Journal of the Mechanical Behavior of Biomedical Materials
Pavlos Texakalidis, Victor M Lu, Yagiz Yolcu, Panagiotis Kerezoudis, Mohammed Ali Alvi, Ian F Parney, Jeremy L Fogelson, Mohamad Bydon
BACKGROUND: Surgical site infections (SSIs) after spine and brain surgery present a major burden to patients and hospitals by increasing morbidity, mortality, and healthcare costs. OBJECTIVE: To review available literature investigating the role of intrawound powdered vancomycin against SSIs after neurosurgical operations. METHODS: All randomized and observational English language studies of intrawound powdered vancomycin use in spinal and cranial surgery were included and analyzed using random-effects modeling...
July 3, 2018: Neurosurgery
Marko Tomov, Nathan Wanderman, Elie Berbari, Bradford Currier, Michael Yaszemski, Ahmad Nassr, Paul Huddleston, Mohamad Bydon, Brett Freedman
BACKGROUND CONTEXT: Surgical site infections (SSI) following spine surgery are debilitating complications to patients and costly to the healthcare system. PURPOSE: Review the impact and cost effectiveness of 5 SSI prevention interventions on SSI rates in an orthopedic spine surgery practice at a major quaternary healthcare system over a 10-year period. STUDY DESIGN: Retrospective observational study. PATIENT SAMPLE: All of the surgical patients of the 5 spine surgeons in our department over a 10-year period were included in this study...
June 2, 2018: Spine Journal: Official Journal of the North American Spine Society
Zachary J Grabel, Allison Boden, Dale N Segal, Stephanie Boden, Andrew H Milby, John G Heller
BACKGROUND CONTEXT: There is growing concern that the microbial profile of surgical site infection (SSI) in the setting of prophylactic vancomycin powder may favor more resistant and uncommon organisms. PURPOSE: To demonstrate the impact of prophylactic intraoperative vancomycin powder on microbial profile, antibiotic regimen, length of stay, and reoperation rate in spine surgical site infection. STUDY DESIGN/SETTING: Retrospective cohort study...
May 30, 2018: Spine Journal: Official Journal of the North American Spine Society
Andrew S Moon, Sakthivel R Manoharan
No abstract text is available yet for this article.
August 2018: Journal of Neurosurgery. Spine
Koji Yamada, Hiroaki Abe, Akiro Higashikawa, Juichi Tonosu, Takashi Kuniya, Koji Nakajima, Haruko Fujii, Kazuki Niwa, Tomohiro Shinozaki, Kenichi Watanabe, Tanaka Sakae, Hiroshi Okazaki
STUDY DESIGN: Retrospective study, using prospectively collected data. OBJECTIVE: To evaluate the impact of evidence-based care bundles for preventing surgical site infections (SSI) in spinal instrumentation surgery. SUMMARY OF BACKGROUND DATA: About half of all SSIs are preventable via evidence-based methods. For successful SSI prevention, the bacterial load must be minimized, and methicillin-resistant Staphylococcus aureus (MRSA) protection must be maximized...
May 22, 2018: Spine
Benigno Monteagudo, Miguel Cabanillas, Pilar Iriarte, Aquilina Ramírez-Santos, Elvira León-Muinos, Daniel González-Vilas, Óscar Suárez-Amor
Clindamycin is a lincomycin-derived antibiotic useful for the treatment of anaerobic and Gram-positive aerobic bacterial infections. Cutaneous adverse reactions are usually maculopapular exanthemas, although hypersensitivity syndrome, acute generalized exanthematous pustulosis, and Stevens-Johnson syndrome have also been reported (1). We report the case of a patient with a maculopapular rash triggered by clindamycin who developed cutaneous lesions on striae distensae (SD). A 47-year-old woman was referred to our clinic for pruritic cutaneous lesions which had started 6 days earlier...
April 2018: Acta Dermatovenerologica Croatica: ADC
Stefanie M Shiels, David J Tennent, Joseph C Wenke
Open fractures become infected despite meticulous debridement and care. Locally applied antibiotics, commonly embedded in polymethylmethacrylate, deliver high doses of drug directly to the fracture site. Direct application of antibiotic powder, which is being applied prophylactically in spine surgery, is a recent interest in the trauma sector, where bacterial biofilms are more prevalent. Traditional antibiotics, such as vancomycin, are poor performers against bacterial biofilms thus are ineffective in delayed treatment...
May 21, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Owoicho Adogwa, Victoria D Vuong, Aladine A Elsamadicy, Daniel T Lilly, Shyam A Desai, Syed Khalid, Joseph Cheng, Carlos A Bagley
BACKGROUND: Wound infections after adult spinal deformity surgery place a high toll on patients, providers, and the healthcare system. Staphylococcus aureus is a common cause of postoperative wound infections, and nasal colonization by this organism may be an important factor in the development of surgical site infections (SSIs). The aim is to investigate whether post-operative surgical site infections after elective spine surgery occur at a higher rate in patients with methicillin-resistant S...
August 2018: World Neurosurgery
Shoichi Haimoto, Ralph T Schär, Yusuke Nishimura, Masahito Hara, Toshihiko Wakabayashi, Howard J Ginsberg
OBJECTIVE Recent studies have demonstrated the efficacy of subfascial intrawound application of vancomycin powder in spine surgery in reducing the rate of surgical site infections (SSIs). However, to date no study has evaluated the efficacy and safety of suprafascial application of vancomycin powder in spine surgery. The purpose of this study was to quantify the rate of SSIs after open instrumented posterior spinal fusion with and without application of suprafascial vancomycin powder and to evaluate the rate of vancomycin powder-related local adverse effects...
August 2018: Journal of Neurosurgery. Spine
Chiaki Horii, Takashi Yamazaki, Hiroyuki Oka, Seiichi Azuma, Satoshi Ogihara, Rentaro Okazaki, Naohiro Kawamura, Yuichi Takano, Jiro Morii, Yujiro Takeshita, Toru Maruyama, Kiyofumi Yamakawa, Motoaki Murakami, Yasushi Oshima, Sakae Tanaka
BACKGROUND CONTEXT: Recent reports suggested that placing vancomycin powder into surgical wounds before closure can prevent surgical site infections (SSIs) in spinal surgery. PURPOSE: The present study aimed to evaluate if intrawound vancomycin powder could prevent SSIs after spinal surgery with posterior instrumentation. STUDY DESIGN: This is a multicenter retrospective cohort study using propensity score matching. PATIENT SAMPLE: We reviewed all spinal surgeries performed with posterior instrumentation from July 2012 to December 2014 at 11 institutions among patients aged ≥15 years...
April 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Craig Winkler, Joel Dennison, Adam Wooldridge, Eneko Larumbe, Cyrus Caroom, Mark Jenkins, George Brindley
Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties...
March 2018: Journal of Clinical Orthopaedics and Trauma
Reina Yao, Terence Tan, Jin Wee Tee, John Street
INTRODUCTION: Surgical site infection (SSI) remains a significant source of morbidity in spine surgery, with reported rates varying from 0.7 to 16%. OBJECTIVE: To systematically review and evaluate the evidence for strategies for prophylaxis of SSI in adult spine surgery in the last twenty years. METHODS: Two independent systematic searches were conducted, at two international spine centers, encompassing PubMed,, Cochrane Database, EBSCO Medline, ScienceDirect, Ovid Medline, EMBASE (Ovid), and MEDLINE...
June 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Brian L Dial, Alexander J Lampley, Cynthia L Green, Rhett Hallows
Purpose: Total hip arthroplasty (THA) is a successful surgery for the treatment of hip osteoarthritis; however, the risk of a post-operative prosthetic joint infection (PJI) remains at 1% to 2%. The purpose of this study was to investigate the safety profile of using vancomycin powder (VP) to reduce infection rates by reviewing acute postoperative complications. Materials and Methods: A retrospective review of 265 consecutive patients undergoing THA was performed...
March 2018: Hip & Pelvis
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