Based on their analysis of 14 retrospective and two prospective studies involving 9,721 patients, they revealed an increasing trend for gram-negative bacteria derived from the wound drainage, which may become an urgent problem when vancomycin powder is used intraoperatively.
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Do Dose-Dependent Microbial Changes Occur during Spine Surgery as a Result of Applying Intrawound Vancomycin Powder?: A Systematic Literature Review.
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