1.Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note
Claudia L CRAVEN ; Simon D THOMPSON ; Ahmed K TOMA ; Laurence D WATKINS
Journal of Korean Neurosurgical Society 2019;62(1):123-129
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.
2-Propanol
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Cerebrospinal Fluid
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Humans
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Hydrocephalus
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Methods
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Microbiota
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Mortality
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Povidone-Iodine
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Skin
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Surgical Wound Infection
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Ventriculoperitoneal Shunt