Skip to main navigation Skip to search Skip to main content

Serum and Wound Vancomycin Levels After Intrawound Administration in Primary Total Joint Arthroplasty

  • Jeremiah D. Johnson
  • , Joseph M. Nessler
  • , Ryan D. Horazdovsky
  • , Sandy Vang
  • , Avis J. Thomas
  • , Scott B. Marston

Research output: Contribution to journalArticlepeer-review

Abstract

Background Periprosthetic joint infection is the most common cause of readmissions after total joint arthroplasty (TJA). Intrawound vancomycin powder (VP) has reduced infection rates in spine surgery; however, there are no data regarding VP in primary TJA. Methods Thirty-four TJA patients received 2 g of VP intraoperatively to investigate VP's pharmacokinetics. Serum and wound concentrations were measured at multiple intervals over 24 hours after closure. Results All serum concentrations were subtherapeutic (<15μg/mL) and peaked 12 hours after closure (4.7μg/mL; standard deviation [SD], 3.2). Wound concentrations were 922 μg/mL (SD, 523) 3 hours after closure and 207 μg/mL (SD, 317) at 24 hours. VP had a half-life of 7.2 hours (95% confidence interval, 7.0-9.3) in TJA wounds. Conclusions VP produced highly therapeutic intrawound concentrations while yielding low systemic levels in TJA. VP may serve as a safe adjunct in the prevention of periprosthetic joint infection.

Original languageEnglish (US)
Pages (from-to)924-928
Number of pages5
JournalJournal of Arthroplasty
Volume32
Issue number3
DOIs
StatePublished - Mar 1 2017

Keywords

  • intrawound vancomycin concentration
  • periprosthetic infection
  • primary total joint arthroplasty
  • prophylactic vancomycin
  • serum vancomycin concentration
  • topical vancomycin

Fingerprint

Dive into the research topics of 'Serum and Wound Vancomycin Levels After Intrawound Administration in Primary Total Joint Arthroplasty'. Together they form a unique fingerprint.

Cite this