Only antibiotic-impregnated suture , a no-shave policy , and double gloving with glove change prior to shunt h and ling , were associated with a significant reduction in shunt infection .
In a hospital with high methicillin-resistant staphylococcus aureus ( MRSA ) prevalence , a r and omized controlled trial found that perioperative vancomycin rather than cefazolin significantly reduced shunt infection rates .
Conclusion Despite wide variation in compliance rates , the implementation of comprehensive surgical protocol s reduced shunt infection in all published studies .
Antibiotic-impregnated suture , a no-shave policy , double gloving with glove change prior to device manipulation , and 5 % chlorhexidine hair wash were associated with significant reductions in shunt infection
Purpose Cerebrospinal fluid shunt infection is associated with patient morbidity and high cost .
We conducted a systematic review of the current evidence of comprehensive surgical protocol s or individual interventions design ed to reduce shunt infection incidence .
Efficacy of intraoperative irrigation with saline for preventing shunt infection.
OBJECT The rate of infection following shunt procedures is unacceptably high . The authors have hypothesized that the key to reducing the shunt infection rate is in reducing bacteria in the operating field and wound . This hypothesis has been tested in a prospect i ve nonr and omized controlled manner . METHODS Data obtained in all patients undergoing shunt insertions or revisions for hydrocephalus performed between October 1 , 2003 , and June 12 , 2009 , were review ed . Starting in August 2006 , we began routinely irrigating the operating field and wound with saline solution from a syringe . Prior to this , we had not used any irrigation techniques , providing an adequate control group ( Group A ) for the effect of the irrigation technique . Prior to November 2007 , we used saline containing amikacin for irrigation ( Group B ) . After that date , we used saline only for irrigation ( Group C ) . RESULTS A total of 150 shunt procedures were performed in 79 girls and 71 boys during the study period . The mean age of all patients was 44.0 + /- 59.1 months . Groups A , B , and C comprised 61 , 40 , and 49 shunt procedures , respectively . There was no statistical difference in age among the 3 groups . Nine infections occurred within 90 days in the postoperative period . The overall infection rate was 6.0 % . Eight infections occurred before introducing the irrigation procedure ( infection rate 13.1 % ) . One infection was noted after introducing irrigation ( Group B [ 0.0 % ] + Group C [ 2.0 % ] ; combined B and C infection rate = 1.1 % ) . There was a statistical difference in the infection rate between Group A and Groups B and C combined ( p = 0.003 ) , Groups A and B ( p = 0.021 ) , and Groups A and C ( p = 0.035 ) . In contrast , no statistical difference was observed between Groups B and C ( p > 0.99 ) . Six of the 9 infections were due to staphylococcal species . CONCLUSIONS An irrigation technique used to reduce bacteria in the operating field and wound is effective for preventing shunt infection .  Irrigation alone , and not antibiotics , contributed to the prophylaxis of shunt infection
Only antibiotic-impregnated suture , a no-shave policy , and double gloving with glove change prior to shunt h and ling , were associated with a significant reduction in shunt infection .
In a hospital with high methicillin-resistant staphylococcus aureus ( MRSA ) prevalence , a r and omized controlled trial found that perioperative vancomycin rather than cefazolin significantly reduced shunt infection rates .
Conclusion Despite wide variation in compliance rates , the implementation of comprehensive surgical protocol s reduced shunt infection in all published studies .
Antibiotic-impregnated suture , a no-shave policy , double gloving with glove change prior to device manipulation , and 5 % chlorhexidine hair wash were associated with significant reductions in shunt infection
Purpose Cerebrospinal fluid shunt infection is associated with patient morbidity and high cost .
We conducted a systematic review of the current evidence of comprehensive surgical protocol s or individual interventions design ed to reduce shunt infection incidence .