Application of Powdered Vancomycin in the Surgical Wound in Haiti

• Status: Completed
• Trial end date: 2022-04-05
• Target enrollment: 0
• Participant gender: All

Summary

Vancomycin, a tricyclic glycopeptide antibiotic, was originally indicated for the treatment of penicillin-resistant S. Aureus. It has a bactericidal action, inhibiting the biosynthesis of the cell wall of Gram-positive bacteria. Various studies have reported the application of intraoperative vancomycin powder to the wound prior to wound closure as a method of antibiotic prophylaxis. Intrasite administration of the drug should theoretically minimize rapid absorption into the systemic circulation, thereby reducing drug-associated side effects. The precipitated concentration gradient between the local wound and the scaffold should also reduce the occurrence of drug resistance. In Haiti, monitoring patients post-operatively is often difficult. The Mortality, Morbidity and Use of Services Survey (EMMUS-VI 2016-2017) reports that the non-use of a health facility is motivated in 58% of cases by the excessively high economic cost of care. Also, SSIs represent a challenge for us clinicians. The best solution to the consequences of SSI in our context is prevention. In the present study, we tested the hypothesis that the use of vancomycin powder in the surgical wound would decrease the occurrence of SSI.

• Phase: Phase 4
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Clinique Ortos
• Treatments: Vancomycin

Criteria

Inclusion Criteria:

• patients with 18 years and older

• lower extremity fractures

Exclusion Criteria:

• patients with impaired consciousness,

• those with an open Gustillo and Anderson type III fracture

• those with a C reactive protein > 6.

• those with date of trauma more than 48 hours

• those with passage of purulent secretion in the wound