The Use of a Novel Antiseptic Irrigant Solution in Combination with Vancomycin Powder Significantly Reduces the Risk of Surgical Site Infections in Orthopedic Trauma Patients

Document Type : RESEARCH PAPER

Authors

1 Samaritan Health Services Department of Orthopedic Surgery, OR, USA

2 Samaritan Health Services Department of Family Medicine, OR, USA

3 Western Univeristy of Health Sciences, Corvallis, OR, USA

10.22038/abjs.2024.81134.3701

Abstract

Objectives: This study aims to evaluate whether using a novel antiseptic irrigant solution combined with 
vancomycin powder can effectively reduce the incidence of surgical site infections (SSIs) in orthopedic 
trauma patients. Specifically, we seek to determine if this combined approach significantly decreases 
SSI rates compared to using vancomycin powder alone. The study also aims to assess the safety and 
efficacy of the phosphate buffer solution, particularly its ability to reduce biofilm formation on surgical 
implants without causing cytotoxic effects. Ultimately, our goal is to provide insights into potential 
clinical practice changes that can enhance infection prevention strategies in orthopedic trauma 
surgeries.
Methods: This retrospective study analyzed 450 orthopedic trauma surgeries for lower extremity fractures at a Level 
Two hospital in Oregon, USA, between January 2021 and October 2023. Patients were stratified based on 
intraoperative irrigation with either vancomycin alone or vancomycin combined with a phosphate buffer irrigation 
solution. Data analysis included demographic characteristics, operative details, and occurrences of SSIs within 90 
days postoperatively.
Results: Among the 450 surgeries analyzed, 18 (8.1%) SSIs occurred in the vancomycin cohort compared to 3 
(1.3%) in the vancomycin and Phosphate buffer cohort. Adjusted logistic regression revealed an 89% reduction in 
the odds of SSIs in the vancomycin and Phosphate buffer cohort (OR: 0.11, 95% CI 0.02-0.35, P=0.001), adjusting 
for age, tobacco use, operative time, and procedure type.
Conclusion: This study underscores the promising role of combined vancomycin and Phosphate buffer irrigation in 
reducing SSI rates in orthopedic trauma surgeries. Further prospective studies are warranted to validate these 
findings and explore optimal infection prevention strategies in diverse surgical settings.
 Level of evidence: IV

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 13, Issue 4
April 2025
Pages 223-228

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History

  • Receive Date: 03 August 2024
  • Revise Date: 06 December 2024
  • Accept Date: 21 December 2024

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