PT  - JOURNAL ARTICLE
AU  - M S Choksey
AU  - I A Malik
TI  - Zero tolerance to shunt infections: can it be achieved?
DP  - 2004 Jan 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 87--91
VI  - 75
IP  - 1
4099  - http://jnnp.bmj.com/content/75/1/87.short
4100  - http://jnnp.bmj.com/content/75/1/87.full
SO  - J Neurol Neurosurg Psychiatry2004 Jan 01; 75
AB  - 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.