Browse > Article
http://dx.doi.org/10.3340/jkns.2020.0088

Ventriculoperitoneal Shunt without Hair Shaving Using Absorbable Suture Materials  

Lee, Yun Ho (Department of Neurosurgery, National Health Insurance Service Ilsan Hospital)
Kwon, Young Sub (Department of Neurosurgery, National Health Insurance Service Ilsan Hospital)
Cho, Jin Mo (Department of Neurosurgery, Catholic Kwandong University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.64, no.1, 2021 , pp. 120-124 More about this Journal
Abstract
Objective : Infection is one of most devastating complications in ventriculoperitoneal (VP) shunt surgery. Preoperative hair removal has traditionally been performed to reduce infectious complications. We performed VP shunt surgeries and evaluated the prevalence of infection in patients who were shaved and those who were unshaven. Methods : A retrospective analysis was conducted of 82 patients with hydrocephalus of various pathologies who underwent VP shunt surgery, with or without having the head shaved, between March 2010 and March 2017. For patients in the non-shaved group (n=36), absorbable suture materials were used for wound closure, and Nylon sutures or staples were used in the shaved group (n=46). We evaluated the infection outcomes of patients in the two groups. Results : There was no difference in the average age of patients in the two groups. In the non-shaved group, there were no infections, while two patients in the shaved group required revision because of shunt infection. Conclusion : Non-shaved shunt surgery may be safe and effective, with no increase of infection rate. We recommend that shunt procedures could be performed without shaving the hair, which may increase patients' satisfaction without increasing infection risk.
Keywords
Ventriculoperitoneal shunt; Hair removal; Infections;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Alexander JW, Fischer JE, Boyajian M, Palmquist J, Morris MJ : The influence of hair-removal methods on wound infections. Arch Surg 118 : 347-352, 1983   DOI
2 Bekar A, Korfali E, Dogan S, Yilmazlar S, Baskan Z, Aksoy K : The effect of hair on infection after cranial surgery. Acta Neurochir (Wien) 143 : 533-536; discussion 537, 2001   DOI
3 Bhatti MI, Leach PA : The incidence of infection for adults undergoing supra-tentorial craniotomy for tumours without hair removal. Br J Neurosurg 27 : 218-220, 2013   DOI
4 Braun V, Richter H : Shaving the hair--is it always necessary for cranial neurosurgical procedures? Acta Neurochir (Wien) 135 : 84-86, 1995   DOI
5 Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, et al. : A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367 : 2471-2481, 2012   DOI
6 Conen A, Walti LN, Merlo A, Fluckiger U, Battegay M, Trampuz A : Characteristics and treatment outcome of cerebrospinal fluid shuntassociated infections in adults: a retrospective analysis over an 11-year period. Clin Infect Dis 47 : 73-82, 2008   DOI
7 Iwami K, Takagi T, Arima T, Takayasu M : Cranial surgery without shaving: practice and results in our hospital. No Shinkei Geka 34 : 901-905, 2006
8 Ko W, Lazenby WD, Zelano JA, Isom OW, Krieger KH : Effects of shaving methods and intraoperative irrigation on suppurative mediastinitis after bypass operations. Ann Thorac Surg 53 : 301-305, 1992   DOI
9 Lo P, Drake JM : Shunt malfunctions. Neurosurg Clin N Am 12 : 695-701, viii, 2001   DOI
10 Orsi GB, Ferraro F, Franchi C : Preoperative hair removal review. Ann Ig 17 : 401-412, 2004
11 Ratanalert S, Saehaeng S, Sripairojkul B, Liewchanpattana K, Phuenpathom N : Nonshaved cranial neurosurgery. Surg Neurol 51 : 458-463, 1999   DOI
12 Ratanalert S, Sriplung H : Social attitudes toward shaving for cranial neurosurgery. Br J Neurosurg 15 : 132-136, 2001   DOI
13 Sarmey N, Kshettry VR, Shriver MF, Habboub G, Machado AG, Weil RJ : Evidence-based interventions to reduce shunt infections: a systematic review. Childs Nerv Syst 31 : 541-549, 2015   DOI
14 Schreffler RT, Schreffler AJ, Wittler RR : Treatment of cerebrospinal fluid shunt infections: a decision analysis. Pediatr Infect Dis J 21 : 632-636, 2002   DOI
15 Tanner J, Moncaster K, Woodings D : Preoperative hair removal: a systematic review. J Perioper Pract 17 : 118-121, 124-132, 2007   DOI
16 Adeleye AO : Nonshaved cranial surgery in black Africans: technical report and a medium-term prospective outcome study. Neurosurg Rev 39 : 449-454, 2016   DOI
17 Albright AL, Pollack IF, Adelson PD : Principles and practice of pediatric neurosurgery. New York : Thieme, 1999
18 Tanner J, Woodings D, Moncaster K : Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev (3) : CD004122, 2006.
19 Winston KR : Hair and neurosurgery. Neurosurgery 31 : 320-329, 1992   DOI
20 Wu X, Liu Q, Jiang X, Zhang T : Prevention options for ventriculoperitoneal shunt infections: a retrospective analysis during a five-year period. Int J Clin Exp Med 8 : 19775-19780, 2015
21 Ratanalert S, Musikawat P, Oearsakul T, Saeheng S, Chowchuvech V : Non-shaved ventriculoperitoneal shunt in Thailand. J Clin Neurosci 12 : 147-149, 2005   DOI