TY  - BOOK
AU  - Dowlati, Ehsan
AU  - Felbaum, Daniel R
TI  - History and Use of Antibiotic Irrigation for Preventing Surgical Site Infection in Neurosurgery: A Scoping Review. [Review]
PY  - 2022///
KW  - *Neurosurgery
KW  - *Surgical Wound Infection
KW  - Anti-Bacterial Agents/tu [Therapeutic Use]
KW  - Antibiotic Prophylaxis
KW  - Humans
KW  - Neurosurgical Procedures/ae [Adverse Effects]
KW  - Surgical Wound Infection/et [Etiology]
KW  - Vancomycin
KW  - MedStar Washington Hospital Center
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Neurosurgery Residency
KW  - Journal Article
KW  - Review
N2  - BACKGROUND: Surgical site infections (SSIs) are surgical complications leading to increased antibiotic usage, higher rates of readmission, prolonged hospitalization, and repeat operations. Use of intraoperative antibiotic irrigation as a form of SSI prophylaxis in neurosurgery may have potential. We aim to review the literature surrounding antibiotic irrigation usage in neurosurgical operations to guide current practice and inform future recommendations; CONCLUSION: Current evidence supports the utility of antibiotic irrigation in preventing neurosurgical SSIs. However, study variability and limitations reduce the generalizability of these results. Given the high morbidity and cost associated with SSIs, randomized control trials are needed to further clarify the best evidence-based practices regarding antibiotic irrigation use in neurosurgical procedures. Copyright (c) 2022 Elsevier Inc. All rights reserved; METHODS: We performed a scoping review of the literature search on PubMed, Ovid, Cochrane, Web of Science, and ClinicalTrials.gov using the terms: ("Neurosurgery" or "Cranial" or "Spinal") and "Antibiotic" and "Irrigation." Data, results, and conclusions were extracted from these studies, analyzed, and summarized; RESULTS: Seventeen studies were included. The use of antibiotic irrigation was first popularized in 1979 with the use of streptomycin irrigation by Leonard Malis. Fourteen studies compared SSI rates to a control or historical cohort and 13 of these studies demonstrated a decrease in SSI rate with antibiotic irrigation. There was greater efficacy of irrigation with vancomycin, gentamicin, or streptomycin use. Results are limited due to variations in choice of antibiotic, type of procedure, instrumentation, and sites of infection across studies. There are also adverse events based on specific antibiotic use that should be considered
UR  - https://dx.doi.org/10.1016/j.wneu.2022.01.098
ER  -