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WP1-12 Reducing infection rates in an intrathecal baclofen service; closing the audit cycle
  1. A Donnelly,
  2. M Balaratnam,
  3. M Murphy,
  4. S Bahadur,
  5. H Padilla,
  6. E Keenan,
  7. R Farrell,
  8. V Stevenson
  1. The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK


Objectives Intrathecal baclofen (ITB) is a recognised treatment strategy for the management of spasticity. We have 30 years of experience, and 160 patients currently receiving treatment.

Design An audit (Jan 13 – Jul 15) demonstrated complication rates of 4.4% (infection) and 4.92% (catheter). After this we recommended 1 vancomycin wash of the pump pocket, 2 occlusive dressing of pressure sores, 3 timely MRSA pre-screening, and this was introduced June-August 2016. We present a re-audit of the service.

Subjects All patients admitted for ITB pump surgery between June 2016 and June 2018.

Methods The database of patients was used, from which the patient notes were reviewed with information relating to each surgical procedure recorded.

Results There were 92 surgical procedures and 78 patients (M 30, F 48). 12 patients had complications, requiring 18 surgical procedures. Out of 18 surgical procedures, 10 were catheter- and 7 pump-related). Our infection rate was lower at 1% of all surgeries (compared with 4.4%), or 0.6% of all ITB pump patients per year (compared with 3.4%), and our catheter complication rate was 6.25% of all patients per year. Our annual incidence rate of all complications was 5.6% in both groups.

Conclusions The infection risk is lower and complication rate remains stable. We will discuss factors which may influence the risk of complication, and consider recommendations for the future.

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