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However, there are differences in the prophylactic programs used for various spinal surgeries. Thus, this systematic review and meta\u2010analysis aimed to evaluate the effectiveness of using intra\u2010wound vancomycin during spinal surgery and to explore the effects of dose\u2010dependence and the method of administration in a subgroup analysis. A total of 628 citations or studies were searched in PubMed, Ovid, Web of Science, and Google Scholar that were published before August 2016 with the terms \u201clocal vancomycin\u201d, \u201cintra\u2010wound vancomycin\u201d, \u201cintraoperative vancomycin\u201d, \u201cintra\u2010site vancomycin\u201d, \u201ctopical vancomycin\u201d, \u201cspine surgery\u201d, and \u201cspinal surgery\u201d. Finally, 19 retrospective cohort studies and one prospective case study were eligible for inclusion in the systematic review and meta\u2010analysis. The odds of developing postsurgical wound infection without prophylactic local vancomycin use were 2.83\u2010fold higher than the odds of experiencing wound infection with the use of intra\u2010wound vancomycin (95% confidence interval, 2.03\u20133.95; <jats:italic>P<\/jats:italic> = 0.083; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 32.2%). The subgroup analysis including the dosage and the method of administration, revealed different results compared to previous research. The value of <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> in the 1\u2010g group was 27.2%, which was much lower than in the 2\u2010g group (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 57.6%). At the same time, the value of <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> was 0.0% (<jats:italic>P<\/jats:italic> = 0.792, <jats:italic>OR<\/jats:italic> = 2.70) when vancomycin powder was directly sprinkled into all layers of the wound. However, there is high heterogenicity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 60.0%, <jats:italic>P<\/jats:italic> = 0.007, <jats:italic>OR<\/jats:italic> = 2.83) when vancomycin powder is not exposed to the bone graft and instrumentation. There are differences found with the method of local application of vancomycin for reducing postoperative wounds and further studies are necessary, including investigations focusing on the dose\u2010dependent effects during spinal or the topical pharmacokinetic and other orthopaedic surgeries.<\/jats:p>","DOI":"10.1111\/os.12356","type":"journal-article","created":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T13:34:59Z","timestamp":1512135299000},"page":"350-358","source":"Crossref","is-referenced-by-count":32,"title":["Effect of Intra\u2010wound Vancomycin for Spinal Surgery: A Systematic Review and Meta\u2010analysis"],"prefix":"10.1111","volume":"9","author":[{"given":"Lun\u2010li","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"},{"name":"Research Center of Translation Medicine Jishou University School of Medicine  Jishou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"},{"name":"Research Center of Translation Medicine Jishou University School of Medicine  Jishou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao\u2010sheng","family":"Yang","sequence":"additional","affiliation":[{"name":"Research Center of Translation Medicine Jishou University School of Medicine  Jishou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010yuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun\u2010hong","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"},{"name":"Research Center of Translation Medicine Jishou University School of Medicine  Jishou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Orthopaedic, Rehabilitation Medicine Center, First People's Hospital of Huaihua Jishou University of the Fourth Affiliated Hospital  Huaihua China"},{"name":"Research Center of Translation Medicine Jishou University School of Medicine  Jishou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-200010000-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200111000-00006"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200010010-00007"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335490712200205"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31818786ff"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0902.020232"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000789"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.12968\/jowc.2016.25.Sup10.S18"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181ff2cb1"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.01.030"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-014-3357-0"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2014.05.022"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000015"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2015.9.4.517"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.9.SPINE13826"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000071"},{"key":"e_1_2_6_18_1","unstructured":"HowickJ ChalmersI GlasziouP et al. 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