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.