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Am J Infect Control. 2012 Jun;40(5):431-3. doi: 10.1016/j.ajic.2011.06.005. Epub 2011 Sep 3.

Self-administered preoperative antiseptic wash to prevent postoperative infection after deep brain stimulation.

Author information

1
Department of Neurosurgery, Center for Functional and Restorative Neurosurgery, University of Pennsylvania, Pennsylvania Hospital, Philadelphia, PA 19104, USA. Casey.Halpern@uphs.upenn.edu

Abstract

BACKGROUND:

Prevention of surgical site infections is critical in deep brain stimulation (DBS). In the present study, we tested the ability of a self-administered preoperative alcohol-based (70% ethyl alcohol) preparation to reduce the rate of postoperative infection after DBS surgery.

METHODS:

This Institutional Review Board-approved retrospective review was conducted at our institution between January 2005 and October 2007 (mean follow-up, 23 months). The participants comprised a consecutive sample of 172 patients with movement disorders who underwent DBS surgery at our institution. Starting in January 2007, all patients were required to use the alcohol-based preparation. These patients (n = 48) were instructed to self-administer the wash on the night before surgery and the morning of surgery. Before this time, no self-administered wash was used (n = 122).

RESULTS:

There was no difference in preoperative skin cleansing between the 2 groups, and all patients received intravenous antibiotics immediately before and after surgery for 24 hours. We compared the rate of postoperative infection in the 2 groups and reviewed other possible factors underlying infection. We found 11 cases of infection (6.47%), all in the group without the preoperative antiseptic wash. The infection rate was 9.02% in the group without the preoperative wash and 0 in the group with the preoperative wash (P < .029). There was no difference between the 2 groups in terms of mean age, duration of operative procedure, or number of microelectrode tracts attempted.

CONCLUSIONS:

Our results support the incorporation of this self-administered antiseptic wash into our standard antiseptic protocol for patients undergoing DBS surgery.

PMID:
21890239
DOI:
10.1016/j.ajic.2011.06.005
[Indexed for MEDLINE]

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