A Randomised Control Trial on the Use of Topical Methicillin in Reducing Post-Operative Ventriculoperitoneal Shunt Infection
- Author:
Sharon Casilda Theophilus
;
Johari Siregar Adnan
- Publication Type:Journal Article
- Keywords:
methicillin, neurosurgery, post-operative wound infection, topical administration, ventriculoperitoneal shunt
- From:Malaysian Journal of Medical Sciences
2011;18(1):30-37
- CountryMalaysia
- Language:English
-
Abstract:
Background: A double-blind randomised control study was conducted on all patients who
were admitted or referred to the Department of Neurosurgery, Sultanah Aminah Hospital, Johor
Bahru, with a diagnosis of hydrocephalus where a ventriculoperitoneal shunt was indicated.
Methods: The period of study was from November 2005 to May 2007, and the follow-up
period was 3 months after surgery. Randomisation was carried out in the operating room prior
to the procedure. The scrub nurse selected a sealed envelope, which contained the assignment of
each patient to 1 of 2 treatment groups: Group 1 patients were treated with topical methicillin, and
Group 2 patients were not treated with topical methicillin. Prophylactic antibiotic, cefuroxime (25
mg/kg) was given intravenously at induction. Standard sterile operative technique was followed in
preparing and draping the patients.
Results: A total of 90 patients were recruited in the study, and 13 (14.4%) patients developed
an infection within 3 months post-operation. Group 1 had a 8.9% risk of infection, and Group 2 had
a 20% risk; however, there was no statistically significant post-operative ventriculoperitoneal shunt
(VPS) infection reduction with the use of topical methicillin in VPS surgery (P = 0.230). Multivariate
analysis showed that only duration of surgery had a significant influence on the incidence of postoperative
VPS infection in the non-methicillin group (P = 0.02). The non-methicillin group had an
8 times greater risk of developing post-operative VPS infection than the methicillin group if surgery
lasted longer than 1 hour.
Conclusion: Topical methicillin had no significance in the reduction of post-operative VPS
infection.
- Full text:W020151022537460034907.pdf
