George T. Pisimisis, Somala Mohammed, Shiva P. Daram, Carlos Bechara, Neal R. Barshes, Peter Lin, Panos Kougias
Baylor College of Medicine, Division of Vascular Surgery and Endovascular Therapy, Houston, TX.
OBJECTIVES: Local vancomycin treatment has been shown to decrease sternal wound complication rates. Whether a similar effect can be achieved at other surgical sites is unknown. This study investigates the effect of local vancomycin on inguinal wound complication rates following vascular procedures.
METHODS: Retrospective analysis was performed on 646 patients who underwent open infra-inguinal and hybrid endovascular procedures between 2006 and 2011. Patients received either pre-operative systemic antibiotics alone (Group A) or in conjunction with intra-operative wound application of vancomycin powder and irrigation (Group B). Wound site infection and dehiscence over a 30-day period were recorded. Fisher exact test and multivariate regression analyses were performed.
RESULTS: There were 424 patients in Group A and 222 patients in Group B. Both groups had similar demographics and distribution of vascular procedures. There was no significant difference in the 30-day incidence of superficial and deep wound infections (OR:0.72, p=0.19) or dehiscence (OR: 1.2, p=0.46) between the two groups after adjusting for type of operation, body mass index, chronic renal dysfunction and presence of chronic lung disease.
CONCLUSIONS: In contrast to other surgical sites, local vancomycin administration did not improve the rate of short term inguinal wound complications following vascular procedures. A prospective study is needed to further delineate the role of local vancomycin adjunct treatment on inguinal wound outcomes.
AUTHOR DISCLOSURES: N. R. Barshes, Nothing to disclose; C. Bechara, Nothing to disclose; S. P. Daram, Nothing to disclose; P. Kougias, Nothing to disclose; P. Lin, Nothing to disclose; S. Mohammed, Nothing to disclose; G. T. Pisimisis, Nothing to disclose.
Posted April 2012