Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note
- Author:
Claudia L CRAVEN
1
;
Simon D THOMPSON
;
Ahmed K TOMA
;
Laurence D WATKINS
Author Information
- Publication Type:Original Article
- Keywords: Wound infection, Surgical; Ventriculo-peritoneal shunt; PVP-Iodine; Skin; Surgical incision
- MeSH: 2-Propanol; Cerebrospinal Fluid; Humans; Hydrocephalus; Methods; Microbiota; Mortality; Povidone-Iodine; Skin; Surgical Wound Infection; Ventriculoperitoneal Shunt
- From:Journal of Korean Neurosurgical Society 2019;62(1):123-129
- CountryRepublic of Korea
- Language:English
- 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.
