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Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note

Journal of Korean Neurosurgical Society 2019년 62권 1호 p.123 ~ 129
 ( Craven Claudia L. ) - National Hospital for Neurology and Neurosurgery Victor Horsley Department of Neurosurgery

 ( Thompson Simon D. ) - National Hospital for Neurology and Neurosurgery Victor Horsley Department of Neurosurgery
 ( Toma Ahmed K. ) - National Hospital for Neurology and Neurosurgery Victor Horsley Department of Neurosurgery
 ( Watkins Laurence D. ) - National Hospital for Neurology and Neurosurgery Victor Horsley Department of Neurosurgery

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.

키워드

Wound infection, Surgical; Ventriculo-peritoneal shunt; PVP-Iodine; Skin; Surgical incision
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