Local vancomycin powder reduces surgical site infections and costs in spine surgery: a retrospective cohort study in a public hospital in Santiago, Chile

Background: Surgical site infections (SSIs) remain a significant complication in spine surgery, leading to increased morbidity, prolonged hospital stays, and substantial healthcare costs. While local vancomycin powder has shown promise in reducing SSIs, its efficacy and economic impact remain understudied, particularly in resource-constrained settings. This study aims to evaluate the impact of local vancomycin powder on SSI rates and associated costs in patients undergoing spine surgery. Methods: A retrospective cohort study was conducted at Hospital Barros Luco Trudeau, Chile, including 205 patients who underwent instrumented spinal surgery between January 2017 and December 2019. Patients were divided into two groups: a control group (n=84) that did not receive vancomycin powder and a vancomycin group (n=121) that received suprafascial vancomycin powder during surgery. Data on SSI rates, hospitalization costs, antibiotic costs, and reoperation costs were extracted from electronic medical records. SSIs were defined according to the Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) guidelines. Statistical analyses included independent t-tests, Chi-squared tests, and Mann-Whitney U tests, with a P value