Reducing ventriculoperitoneal shunt infection with intraoperative glove removal.
Journal
Infection control and hospital epidemiology
ISSN: 1559-6834
Titre abrégé: Infect Control Hosp Epidemiol
Pays: United States
ID NLM: 8804099
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
pubmed:
20
4
2022
medline:
17
2
2023
entrez:
19
4
2022
Statut:
ppublish
Résumé
Contamination of ventriculoperitoneal shunts (VPS) by cutaneous flora, particularly coagulase-negative staphylococci, is a common cause of shunt infection and failure, leading to prolonged hospital stay, higher costs of care, and poor outcomes. Glove contamination may occur during VPS insertion, increasing risk of such infections. We performed a systematic search of the PubMed database for studies published January 1, 1970, through August 31, 2021 that documented VPS infection rates before and after implementing a practice of double gloving with change or removal of the outer glove immediately prior to shunt insertion. Among 272 reports screened, 4 were eligible for review based on our inclusion criteria. The incidence of VPS infection was reduced in all 4 quasi-experimental studies with an aggregate incidence of VPS infection of 11.8% before the change in intraoperative protocol and 4.9% after protocol change. One study documented reduced hospital stay with this change in protocol. The risk of VPS infection is reduced by removal or replacement of the outer surgical gloves immediately prior to intraoperative insertion of a VPS as part of an infection control bundle.
Sections du résumé
BACKGROUND
Contamination of ventriculoperitoneal shunts (VPS) by cutaneous flora, particularly coagulase-negative staphylococci, is a common cause of shunt infection and failure, leading to prolonged hospital stay, higher costs of care, and poor outcomes. Glove contamination may occur during VPS insertion, increasing risk of such infections.
METHODS
We performed a systematic search of the PubMed database for studies published January 1, 1970, through August 31, 2021 that documented VPS infection rates before and after implementing a practice of double gloving with change or removal of the outer glove immediately prior to shunt insertion.
RESULTS
Among 272 reports screened, 4 were eligible for review based on our inclusion criteria. The incidence of VPS infection was reduced in all 4 quasi-experimental studies with an aggregate incidence of VPS infection of 11.8% before the change in intraoperative protocol and 4.9% after protocol change. One study documented reduced hospital stay with this change in protocol.
CONCLUSION
The risk of VPS infection is reduced by removal or replacement of the outer surgical gloves immediately prior to intraoperative insertion of a VPS as part of an infection control bundle.
Identifiants
pubmed: 35438070
pii: S0899823X22000708
doi: 10.1017/ice.2022.70
pmc: PMC9929712
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
234-237Références
Pediatr Neurosurg. 2009;45(5):325-36
pubmed: 19907195
J Neurosurg Pediatr. 2014 Jan;13(1):101-6
pubmed: 24206346
J Neurosurg Pediatr. 2011 Jul;8(1):22-9
pubmed: 21721884
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Int Wound J. 2020 Jun;17(3):722-728
pubmed: 32073232
J Korean Neurosurg Soc. 2021 Jan;64(1):120-124
pubmed: 32492983
Orthop Traumatol Surg Res. 2012 Jun;98(4):432-40
pubmed: 22578871
Am J Infect Control. 2010 Mar;38(2):154-8
pubmed: 19822380
J Bone Joint Surg Br. 2005 Apr;87(4):556-9
pubmed: 15795210
Surg Infect (Larchmt). 2016 Aug;17(4):436-42
pubmed: 26981792
Childs Nerv Syst. 2015 Apr;31(4):541-9
pubmed: 25686893
Cochrane Database Syst Rev. 2019 Jun 04;6:CD012902
pubmed: 31163089
J Neurosurg Pediatr. 2017 Sep;20(3):216-224
pubmed: 28665241
J Neurosurg Pediatr. 2020 Jul 24;26(5):504-512
pubmed: 32707540
J Neurosurg. 2019 Feb 15;132(3):755-759
pubmed: 30771771
Pediatr Neurosurg. 2009;45(6):456-60
pubmed: 20110759
Ann Surg. 2014 Mar;259(3):591-7
pubmed: 24045444
J Hosp Infect. 2011 Jun;78(2):156-7
pubmed: 21497947
Pediatr Int. 2018 Dec;60(12):1056-1061
pubmed: 30290047
Pediatr Neurosurg. 2020;55(2):81-85
pubmed: 32610322
J Neurosurg Pediatr. 2010 Jun;5(6):569-72
pubmed: 20515328
Br J Neurosurg. 2018 Apr;32(2):196-200
pubmed: 29706112
Cochrane Database Syst Rev. 2018 Feb 06;2:CD012653
pubmed: 29406579
Childs Nerv Syst. 2020 Feb;36(2):401-409
pubmed: 31455997
J Neurosurg. 2006 Jan;104(1 Suppl):5-8
pubmed: 16509473
J Spinal Disord Tech. 2015 Jul;28(6):E343-6
pubmed: 23563341
J Neurosurg. 1979 Dec;51(6):804-11
pubmed: 501424
Lancet. 2019 Oct 26;394(10208):1530-1539
pubmed: 31522843
Eur J Vasc Endovasc Surg. 2000 Mar;19(3):283-7
pubmed: 10753692
Am J Infect Control. 2017 Aug 1;45(8):866-871
pubmed: 28526307
J Neurosurg. 2001 Feb;94(2):195-201
pubmed: 11213954
Childs Nerv Syst. 2007 Nov;23(11):1251-61
pubmed: 17705062
J Neurosurg Pediatr. 2011 Dec;8(6):593-9
pubmed: 22132918
ANZ J Surg. 2019 Sep;89(9):1009-1015
pubmed: 30497094
Br J Neurosurg. 2017 Aug;31(4):452-458
pubmed: 27626705
Pediatr Neurosurg. 2003 Dec;39(6):285-90
pubmed: 14734861
Br J Neurosurg. 2008 Oct;22(5):675-7
pubmed: 19016119
Childs Nerv Syst. 2018 Dec;34(12):2407-2414
pubmed: 30132097
Neurology. 2000 Aug 22;55(4):576-8
pubmed: 10953197