By Nancy Melville
Washington, DC — The use of intrawound vancomycin powder shows efficacy in the prevention of spinal surgical site infections, with the greatest benefit in high-volume institutions, according to a meta-analysis.
“The evidence for the use of vancomycin powder is still developing, but we found the greatest impact appears to be in high-volume spinal surgery institutions with high baseline infection rates and among patients with higher-risk factors, such as obesity, diabetes, or having large intermittent procedures,” said first author Nickalus R. Khan, MD, from the University of Tennessee Health Sciences Center in Memphis. 
Their findings were presented here at the American Association of Neurological Surgeons (AANS) 83rd Annual Meeting.
The meta-analysis included 355 spinal surgery studies and focused on 9 studies that included control groups with patients who were not treated with vancomycin powder.
Eight of the studies included level III evidence, and one study was a randomized controlled trial with level II evidence.