Evaluation of Topical Vancomycin for Surgical Site Infection Prophylaxis in Major Cranial Surgeries at a Tertiary Healthcare Center in Abuja

OBJECTIVES: This study aimed to determine the effectiveness of intrawound vancomycin in preventing surgical site infection (SSI) in major cranial surgeries. MATERIALS AND METHODS: It was a prospective, randomized controlled, interventional study conducted in the neurosurgery department of our institution on all adult patients who had major cranial surgeries over 12 months. The consented patients were randomized into either Vancomycin group or control. A predesigned study pro forma was used to collect patients' clinical data including risk factors for SSIs, clinical presentation, indication for surgery, type of surgical intervention and postoperative wound findings. Patients were followed up for 3 months postoperatively. RESULTS: A total of 104 patients were studied with equal numbers in each group. The incidence of SSI was 10.6% with no significant difference between the two groups. There was however a 17% relative risk reduction in SSI in Vancomycin group. Only two organisms were responsible for SSI: Staphylococcus aureus (91%) and enterococcus (9%). CONCLUSION: This study showed that intrawound vancomycin use does not significantly reduce incidence of SSI post major cranial surgery, however the 17% relative risk reduction suggests a potential clinical utility of topical vancomycin for SSI prophylaxis.