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 .
A no-touch technique protocol to diminish cerebrospinal fluid shunt infection.
BACKGROUND Cerebrospinal fluid ( CSF ) shunts become infected primarily by bacterial organisms indigenous to the patient 's skin flora , but bacteria from the operating room environment , hospital , or no obvious source may also infect a shunt . To decrease the incidence of shunt infection , a no-touch technique protocol was developed and utilized in a prospect i ve manner . METHODS A before-after trial analysis was performed to compare the infection rates between patients who had CSF shunts placed using the no-touch technique protocol versus patients who had surgery without the protocol . Patients were stratified by age , etiology of hydrocephalus , type of shunt surgery , and presence of a contaminated skin wound , namely , tracheostomy , gastrostomy-jejunostomy , colostomy , or halo . The differences in infection rates were analyzed with the Fisher exact test with midpoint value correction , and st and ard statistical methods were used to calculate the 90 % confidence interval odds ratio and number to treat . RESULTS The no-touch technique protocol result ed in a clinical ly significant threefold decrease in shunt infection rate from 9.1 % to 2.9 % ( p = 0.058 at 0.10 level , odds ratio 0.305 , confidence interval 0.084 - 1.11 ) , and a near threefold decrease in the infection rate per patient from 11.3 % to 3.9 % ( p = 0.032 at 0.10 level , odds ratio 0.243 , confidence interval 0.065 - 0.906 ) . CONCLUSIONS The no-touch technique protocol as described herein is a useful method to decrease shunt infection . A larger prospect i ve , r and omized , multicenter clinical trial is encouraged to stringently assess the efficacy of the protocol
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 .