Use of intraoperative vancomycin powder and its effects on the incidence of surgical site infection in orthopaedic trauma: a systematic review with meta-analysis.

Study Summary

7 studies including 2764 adult patients undergoing orthopaedic trauma surgery were included in this systematic review and meta-analysis comparing intraoperative powdered vancomycin plus systemic antibiotics vs systemic antibiotics alone. Outcomes of interest included overall surgical site infection (SSI), gram-positive SSI, gram-negative SSI, fracture-related infection, and safety. Meta-analysis demonstrated that powdered vancomycin significantly reduced overall SSI and gram-positive SSI, whereas no significant reduction was observed in gram-negative infections. The findings suggest that intrawound powdered vancomycin is a safe and cost-effective adjunct that may reduce postoperative infection risk, particularly infections caused by gram-positive organisms, in orthopaedic trauma surgery.