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1.
Journal of Korean Neurosurgical Society ; : 123-129, 2019.
Article in English | WPRIM | ID: wpr-788741

ABSTRACT

OBJECTIVE: Ventriculoperitoneal (VP) shunt surgery is a common and effective treatment for hydrocephalus and cerebrospinal fluid disorders. Infection remains a major cause of morbidity and mortality after a VP shunt. There is evidence that a deep skin flora microbiome may have a role to play in post-operative infections. In this technical note, we present a skin preparation technique that addresses the issue of the skin flora beyond the initial incision.METHODS: The patient is initially prepped, as standard, with. a single layer of 2% CHG+70% isopropyl alcohol. The novel stage is the ‘double incision’ whereby an initial superficial incision receives a further application of povidone-iodine prior to completing the full depth incision.RESULTS: Of the 84 shunts inserted using the double-incision method (September 2015 to September 2016), only one developed a shunt infection.CONCLUSION: The double incision approach to skin preparation is a unique operative stage in VP shunt surgery that may have a role to play in reducing acute shunt infection.


Subject(s)
Humans , 2-Propanol , Cerebrospinal Fluid , Hydrocephalus , Methods , Microbiota , Mortality , Povidone-Iodine , Skin , Surgical Wound Infection , Ventriculoperitoneal Shunt
2.
Journal of Korean Neurosurgical Society ; : 123-129, 2019.
Article in English | WPRIM | ID: wpr-765312

ABSTRACT

OBJECTIVE: Ventriculoperitoneal (VP) shunt surgery is a common and effective treatment for hydrocephalus and cerebrospinal fluid disorders. Infection remains a major cause of morbidity and mortality after a VP shunt. There is evidence that a deep skin flora microbiome may have a role to play in post-operative infections. In this technical note, we present a skin preparation technique that addresses the issue of the skin flora beyond the initial incision. METHODS: The patient is initially prepped, as standard, with. a single layer of 2% CHG+70% isopropyl alcohol. The novel stage is the ‘double incision’ whereby an initial superficial incision receives a further application of povidone-iodine prior to completing the full depth incision. RESULTS: Of the 84 shunts inserted using the double-incision method (September 2015 to September 2016), only one developed a shunt infection. CONCLUSION: The double incision approach to skin preparation is a unique operative stage in VP shunt surgery that may have a role to play in reducing acute shunt infection.


Subject(s)
Humans , 2-Propanol , Cerebrospinal Fluid , Hydrocephalus , Methods , Microbiota , Mortality , Povidone-Iodine , Skin , Surgical Wound Infection , Ventriculoperitoneal Shunt
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