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http://dx.doi.org/10.3340/jkns.2017.0282

Superficial and Deep Skin Preparation with Povidone-Iodine for Ventriculoperitoneal Shunt Surgery : A Technical Note  

Craven, Claudia L. (Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery)
Thompson, Simon D. (Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery)
Toma, Ahmed K. (Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery)
Watkins, Laurence D. (Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery)
Publication Information
Journal of Korean Neurosurgical Society / v.62, no.1, 2019 , pp. 123-129 More about this Journal
Abstract
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.
Keywords
Wound infection, Surgical; Ventriculo-peritoneal shunt; PVP-Iodine; Skin; Surgical incision;
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