Zero tolerance to shunt infections: can it be achieved?
OBJECTIVE: To evaluate the rigid application of a technique of shunt placement aimed at the eradication of postoperative shunt infection in neurosurgical practice. METHOD: All shunt procedures were performed or closely supervised by the senior author ( MSC). The essentials were the use of intravenous peri- and postoperative antimicrobials, rigid adherence to classical aseptic technique, liberal use of topical antiseptic (Betadine), and avoidance of haematomas. RESULTS: Of 176 operations, 93 were primary procedures; 33 patients underwent revisions, some multiple. Only one infection occurred, seven months postoperatively, secondary to appendicitis with peritonitis. The infecting Streptococcus faecalis appeared to ascend from the abdominal cavity. CONCLUSION: A rigidly applied protocol and strict adherence to sterile technique can reduce shunt infections to a very low level.[1]References
- Zero tolerance to shunt infections: can it be achieved? Choksey, M.S., Malik, I.A. J. Neurol. Neurosurg. Psychiatr. (2004) [Pubmed]
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