Burn wound excision and massive blood transfusion did not affect perioperative vancomycin levels

Introduction: The effect of burns surgery that requires intraoperative transfusion of five or more units of blood on serum vancomycin levels was assessed. Methods: Serum vancomycin levels were measured 10 min and 6 h after vancomycin administration with surgery being performed in the interval. The following day the same dose of vancomycin was given and serum vancomycin levels measured at the same times without intervening surgery. Results: Thirteen operations involving nine patients who required a mean blood transfusion of 9.2 units were studied. There was very little difference between 10-min levels, 6-h levels and the change over interval (absolute and percentage) on the day of surgery and the following day. The recorded serum levels were often at the lower end of the desired range, especially in patients who underwent the larger operations. This was the case on both day of surgery and the control day. Conclusions: Large volume blood loss and replacement during burns surgery did not significantly affect perioperative vancomycin levels.