TY - JOUR T1 - Zero tolerance to shunt infections: can it be achieved? JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 87 LP - 91 VL - 75 IS - 1 AU - M S Choksey AU - I A Malik Y1 - 2004/01/01 UR - http://jnnp.bmj.com/content/75/1/87.abstract N2 - 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. ER -