Neurosurgery
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Surgical site infection (SSI) is an expensive complication associated with spine surgery. The application of intrawound vancomycin is rapidly emerging as a solution to reduce SSI. The impact of intrawound vancomycin has not been systematically studied in a well-designed multicenter study. We determine whether intrawound vancomycin application was associated with reduced risk of SSI in patients after spine surgery. ⋯ Intrawound application of vancomycin after elective spine surgery was associated with reduced risk of SSI and return to OR associated with SSI, even after controlling for confounding variables.
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Clinical prediction and decision rules use evidence-based medicine to assist clinicians in diagnosing and treating illness. Although widespread in modern medical practice, there are relatively few clinical rules for neurosurgical conditions. ⋯ It also summarizes a list of clinical rules published for neurosurgical illnesses and analyzes each rule for how it was derived and whether it was validated and/or evaluated compared with similar rules. It reports on whether the implementation of each rule was studied and grades the overall quality of each report.