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. 2004 Jan;75(1):87-91.

Zero tolerance to shunt infections: can it be achieved?

M S Choksey  1 , I A Malik
Affiliations

Zero tolerance to shunt infections: can it be achieved?

M S Choksey et al. J Neurol Neurosurg Psychiatry. 2004 Jan.

Abstract

Objective: To evaluate the rigid application of a technique of shunt placement aimed at the eradication of postoperative shunt infection in neurosurgical practice.

Method: All shunt procedures were performed or closely supervised by the senior author (MSC). The essentials were the use of intravenous peri- and postoperative antimicrobials, rigid adherence to classical aseptic technique, liberal use of topical antiseptic (Betadine), and avoidance of haematomas.

Results: Of 176 operations, 93 were primary procedures; 33 patients underwent revisions, some multiple. Only one infection occurred, seven months postoperatively, secondary to appendicitis with peritonitis. The infecting Streptococcus faecalis appeared to ascend from the abdominal cavity.

Conclusion: A rigidly applied protocol and strict adherence to sterile technique can reduce shunt infections to a very low level.

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