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KMID : 1001920190620010123
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Journal of Korean Neurosurgical Society
2019 Volume.62 No. 1 p.123 ~ p.129
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Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note
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Craven Claudia L.
Thompson Simon D.
Toma Ahmed K.
Watkins Laurence D.
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Abstract
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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.
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KEYWORD
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Wound infection, Surgical, Ventriculo-peritoneal shunt, PVP-Iodine, Skin, Surgical incision
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