Ventriculoperitoneal shunt surgery in pediatrics: Does preoperative skin antisepsis with Chlorhexidine/alcohol reduce postoperative shunt infection rate?

BACKGROUND

In pediatrics, shunt infection is considered the most common complication of ventriculoperitoneal (VP) shunts insertion and the main cause of shunt failure. Careful surgical technique and hygienic skin preparations are highly important for prevention of shunt infections. Our objective was to assess the significance of using preoperative chlorhexidine/alcohol as a skin antiseptic in reducing the infection rate in pediatric VP shunts surgery.

PATIENTS AND METHODS

A retrospective, case control study conducted on 80 pediatric patients with active hydrocephalus. The control group (a single step of preoperative skin antisepsis using povidone-iodine and isopropyl alcohol) included 40 patients operated from January 2019 to June 2020 and the study group (two steps of preoperative skin antisepsis using 2% chlorhexidine gluconate in 70% isopropyl alcohol as a first step followed by povidone-iodine as a second step) included 40 patients operated from July 2020 to January 2022.

RESULTS

For the entire sample, shunt infections were encountered in 11 cases (13.7%). Shunt infection was significantly higher in preterm babies (P = 0.010), patients with previous shunt revision (P < 0.001) and those with previous shunt infection (P < 0.001). The incidence of infection in the control group was 22.5% versus 5% in study group, with a statistically significant difference (P = 0.023).

CONCLUSIONS

Two steps of preoperative skin antisepsis using chlorhexidine/alcohol as a first step followed by povidone-iodine scrub solution may significantly reduce the infection rate in pediatric VP shunts surgery.

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare that they have no conflict of interest.