Application of Powdered Vancomycin in the Surgical Wound in Haiti
Status:
Completed
Trial end date:
2022-04-05
Target enrollment:
Participant gender:
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.