3 months post op...

[annm]

I recently heard of a concern that when my daughter has her teeth cleaned that she needs a round of antibiotics the day before. First of all, is it true, I have tried to contact the nurse and haven't gotten a return call, second of all, does this apply to colds, flu's and other illnesses? I'm worried now because over the last couple of days she has caught a cold and I don't want a secondary problem to arise...

[leahdragonfly]

Hi,

I wouldn't worry at all about your daughter's hardware with colds/flu/etc. The main concern is situations which involve bacteria in the bloodstream. Surgeons seems to vary on this---my surgeon doesn't recommend antibiotics for routine teeth cleaning, but does recommend them for any dental work involving drilling for one year. My daughter had vertebral staples put in at age 8, and her surgeon had her take antibiotics before routine teeth cleaning for one year.

Try not to worry over the weekend, and check in again with the surgeon's office Monday if you are concerned.

[Pooka1]

Hi. I agree that surgeons seem to differ and you just need to ask your surgeon.

Our surgeon said antibiotics were not necessary even for tooth extraction post op to spinal fusion. He said the only time antibiotics are needed for tooth extraction is having had knee replacement or other whole joint replacements.

But when I told the oral surgeon this, he wasn't so certain and he prescribed a short course of antibiotics for my daughter.

By the way, colds and flu are due to virus, not bacteria and so antibiotics won't touch that even if it was in the blood which it is not to my knowledge.

[jackieg412]

I worked many years in dentistry--some dentist would rather give a very short course of antibiotics{6 Tablets}then ever have anyone face a problem. Knowing what I have seen through the years--i would say take the antibiotics if you can.

[titaniumed]

Hi Ann

This is off the SRS site.....

If I have a spinal fusion, will I need antibiotics before dental work?
This question is controversial. It refers to the possibility of infection in spine implants after dental work. However, there are efforts underway to develop formal guidelines regarding the use of prophylactic antibiotics before dental work in patients who have previously had spine implants inserted in their backs.

Please talk with your spine surgeon about this before having dental work.

http://www.srs.org/patient_and_famil..._scoliosis.htm


Here is an old thread on this subject.
http://www.scoliosis.org/forum/showt...otics++dentist

Ed

[titaniumed]

On a slightly different note.....

Something new....Just add a little “pixie dust”. What would we do without our ARMY surgeons?

http://www.urmc.rochester.edu/news/s...ex.cfm?id=3459

Ed

[laakea77]

love the pixie dust...wonder if it really is safe?

[Pooka1]

From the recent IMAST meeting...

http://www.srs.org/UserFiles/file/IM...k-FINAL_v2.pdf

P. 91

45. Comparative Effectiveness and Cost-Benefit Analysis of
Topical Vancomycin Powder in Posterior Spinal Fusion for
Spine Trauma and Degenerative Spine Disease
Michael C. Dewan, MD
; Saniya S. Godil, MD; Scott L. Zuckerman, MD; Stephen
Mendenhall; David Shau; Scott L. Parker, MD; Clinton J. Devin, MD; Matthew J.
McGirt, MD
USA
Summary:
We introduced local vancomycin powder into our practice of posterior
spinal fusion for spine trauma and degenerative spine disease and set out to
determine the value and cost benefit of using vancomycin powder in surgical sites
to prevent postoperative infections. The use of topical vancomycin powder was
associated with significant reduction in incidence of postoperative infection, as well
as infection-related cost. Use of adjuvant vancomycin powder is an effective and
cost-saving option for preventing postoperative infections in posterior spinal fusion.
Introduction:
Surgical site infection(SSI) is a morbid complication with high
cost in management of surgical spine patients. In this era of healthcare reforms,
adjuvant therapies that not only improve quality, but also decrease cost, are
considered of highest value. We introduced local vancomycin powder into our
practice of posterior spinal fusion for spine trauma and degenerative spine disease
patients and set out to determine the value and cost benefit of using vancomycin
powder in surgical sites to prevent postoperative infections.
Methods:
A retrospective review of patients undergoing posterior spinal fusion
for trauma or degenerative disease was performed. One group(control group)
received standard systemic prophylaxis only; another(treatment group) received
1g of local vancomycin powder spread over the surgical wound in addition to
systemic prophylaxis. Incidence of infection was the primary outcome evaluated.
Billing records were reviewed to determine infection-related cost. The payers cost
was estimated to be 70% of billing cost.
Results:
A total of 110 patients(Control=54, treatment=56) with spine
trauma and 455 patients(Control=318, treatment=137) with degenerative
disease were included. Control and treatment groups were similar at baseline.
Use of vancomycin powder led to significant reduction in infection rate[Spine
trauma: 13% versus 0%(p=0.02); Degenerative spine disease: 5.7% versus
0%(p=0.001)]. No adverse effects of vancomycin use occurred. Mean cost of
post-operative surgical site infection was $33,705 for spine trauma and $29,440
for degenerative spine disease. Use of vancomycin powder led to cost savings of
$438,165 per 100 posterior spinal fusions performed for traumatic injuries and
$163,408 per 100 posterior spinal fusions performed for elective degenerative
pathology.
Conclusion:
The use of topical vancomycin powder was associated with a
significant reduction in incidence of postoperative infection, as well as infection-
related cost. Use of adjuvant vancomycin powder is an effective and cost-saving
option for preventing postoperative infections in posterior spinal fusion.

[jrnyc]

well, gosh...
they could have asked Tinker Bell about it years ago...
she would have told them about Pixie Dust...
obviously, an ancient cure-all of the highest order!!

jess...and Sparky

[titaniumed]

Sharon

Thanks for posting.....The 2013 IMAST link actually deserves its own titled thread. There is a MOUNTAIN of information here.

I wonder if all the surgeons that attended this meeting, and other surgeons that read this data will start using Vancomycin? Seems like a simple solution to combat post surgical infection......

We have had forum members here at NSF with post operative infections.....The threads and posts are here! They also go through hell and come back after multiple revisions. Man-o-man!

Should a patient request pixie dust? Hmmm......

Ed