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Self-administered preoperative antiseptic wash to prevent postoperative infection after deep brain stimulation.
MedLine Citation:
PMID:  21890239     Owner:  NLM     Status:  Publisher    
BACKGROUND: Prevention of surgical site infections is critical in deep brain stimulation (DBS). In the present study, we tested the ability of a self-administered preoperative alcohol-based (70% ethyl alcohol) preparation to reduce the rate of postoperative infection after DBS surgery. METHODS: This Institutional Review Board-approved retrospective review was conducted at our institution between January 2005 and October 2007 (mean follow-up, 23 months). The participants comprised a consecutive sample of 172 patients with movement disorders who underwent DBS surgery at our institution. Starting in January 2007, all patients were required to use the alcohol-based preparation. These patients (n = 48) were instructed to self-administer the wash on the night before surgery and the morning of surgery. Before this time, no self-administered wash was used (n = 122). RESULTS: There was no difference in preoperative skin cleansing between the 2 groups, and all patients received intravenous antibiotics immediately before and after surgery for 24 hours. We compared the rate of postoperative infection in the 2 groups and reviewed other possible factors underlying infection. We found 11 cases of infection (6.47%), all in the group without the preoperative antiseptic wash. The infection rate was 9.02% in the group without the preoperative wash and 0 in the group with the preoperative wash (P < .029). There was no difference between the 2 groups in terms of mean age, duration of operative procedure, or number of microelectrode tracts attempted. CONCLUSIONS: Our results support the incorporation of this self-administered antiseptic wash into our standard antiseptic protocol for patients undergoing DBS surgery.
Casey H Halpern; Grant W Mitchell; Aaron Paul; Daniel R Kramer; Kathryn R McGill; Dana Buonacuore; Marie Kerr; Jurg L Jaggi; John J Stern; Gordon H Baltuch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-3
Journal Detail:
Title:  American journal of infection control     Volume:  -     ISSN:  1527-3296     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004854     Medline TA:  Am J Infect Control     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Department of Neurosurgery, Center for Functional and Restorative Neurosurgery, University of Pennsylvania, Pennsylvania Hospital, Philadelphia, PA.
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