Rehman Atiq-Ur, Rehman Tausif-Ur, Bashir Hassaan H, Gupta Vikas
Department of Neurosurgery, King Fahd Specialists Hospital, Al-Qassim, Saudi Arabia.
J Neurosurg Pediatr. 2010 Jun;5(6):569-72. doi: 10.3171/2010.2.PEDS09151.
Postoperative shunt infection is the most common and feared complication of ventriculoperitoneal (VP) shunt placement for treatment of hydrocephalus. The rate of shunt infection is highest in the 1st postoperative month. The most common organisms responsible for shunt infection include coagulase-negative Staphylococcus and Staphylococcus aureus. This suggests a transfer of patient's skin flora via the surgeons' glove as a possible means of infection. The authors conducted a study to determine if the rate of postoperative shunt infections could be reduced simply by changing gloves before handling the shunt catheter.
A total of 111 neonates born with congenital hydrocephalus requiring a VP shunt were enrolled retrospectively and divided into 2 groups: a control group of 54 neonates treated with standard protocol VP shunt placement (Group A) and a treatment group of 57 neonates in whom, after initially double gloving, the outer pair of gloves was removed before handling the shunt catheter (Group B). Shunt infection rates were compared up to 6 months postoperatively.
There was a statistically significant reduction of infection rate from 16.33% in Group A (control) to 3.77% in Group B (p = 0.0458).
The study shows that a changing of gloves before handling the shunt catheter may be a simple and cost-effective way to reduce the burden of postoperative shunt infections.
术后分流感染是脑室腹腔（VP）分流术治疗脑积水最常见且令人担忧的并发症。分流感染率在术后第1个月最高。导致分流感染的最常见病原体包括凝固酶阴性葡萄球菌和金黄色葡萄球菌。这表明患者的皮肤菌群通过外科医生的手套转移可能是一种感染途径。作者进行了一项研究，以确定仅通过在处理分流导管前更换手套是否能降低术后分流感染率。
回顾性纳入111例先天性脑积水需行VP分流术的新生儿，分为2组：54例采用标准方案行VP分流术的新生儿为对照组（A组），57例新生儿在最初戴双层手套后，在处理分流导管前摘掉外层手套作为治疗组（B组）。比较术后6个月内的分流感染率。
感染率从A组（对照组）的16.33%显著降低至B组的3.77%（p = 0.0458）。
该研究表明，在处理分流导管前更换手套可能是一种简单且经济有效的减轻术后分流感染负担的方法。
