Self-administered preoperative antiseptic wash to prevent postoperative infection after deep brain stimulation

Halpern, Casey H.; Mitchell, Grant W.; Paul, Aaron; Kramer, Daniel R.; McGill, Kathryn R.; Buonacuore, Dana; Kerr, Marie; Jaggi, Jurg L.; Stern, John J.; Baltuch, Gordon H.

doi:10.1016/j.ajic.2011.06.005

Cited by 19 publications

(15 citation statements)

References 10 publications

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“…In total, 11 infections were noted, all of which were in the group that did not self-administer the antiseptic wash. This difference was statistically significant [25]. …”

Section: Discussionmentioning

confidence: 99%

The Risk of Hardware Infection in Deep Brain Stimulation Surgery Is Greater at Impulse Generator Replacement than at the Primary Procedure

Pepper¹,

Zrinzo²,

Mirza³

et al. 2012

Stereotact Funct Neurosurg

136

112

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Background/Aims: Infection of implanted hardware after deep brain stimulation (DBS) has a significant impact on patient morbidity. We examined all patients who underwent DBS procedures over the last 9 years in our centre to assess the infection rate and possible factors related to surgery that may predispose to infection. Methods: Surgical reports and clinical notes were reviewed in 273 consecutive patients who underwent a total of 519 DBS-related procedures in our institute between November 2002 and September 2011. Results: Sixteen separate hardware-related infections occurred in 11 patients. Infections occurred in 3% of all procedures and 4% of all patients. The infection rate after implantable pulse generator (IPG) replacement surgery was more than three times higher than after de novo DBS surgery. In addition, male patients were more likely to develop device-related infections. Conclusions: It is unclear why infection rates should be more than three times higher after IPG replacement surgery than after the de novo procedure. The former is a shorter and simpler procedure to conduct. Perhaps the use of better antimicrobial protection and rechargeable batteries may be useful strategies to reduce infections following IPG revision surgery.

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“…In total, 11 infections were noted, all of which were in the group that did not self-administer the antiseptic wash. This difference was statistically significant [25]. …”

Section: Discussionmentioning

confidence: 99%

The Risk of Hardware Infection in Deep Brain Stimulation Surgery Is Greater at Impulse Generator Replacement than at the Primary Procedure

Pepper¹,

Zrinzo²,

Mirza³

et al. 2012

Stereotact Funct Neurosurg

136

112

View full text Add to dashboard Cite

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“…The rate of infection, especially the 2.01%, compares favorably across published studies. Still, it is difficult to compare percentages directly because different authors use a variety of criteria to define postsurgical DBS infection [7,8,9,10,11,12,13,14,15,16,17,18]. …”

Section: Discussionmentioning

confidence: 99%

“…Reported infection rates have varied considerably through the literature from 0.4 to 23%, likely secondary to differing surgical techniques, infection-preventative techniques, definitions of infection, infection computation (e.g. per surgery or per patient) and patient population [7,8,9,10,11,12,13,14,15,16,17,18]. The physical, economic and emotional repercussions of treating an infection and potential subsequent removal of the DBS hardware can be considerable [17].…”

Section: Introductionmentioning

confidence: 99%

The Factors Involved in Deep Brain Stimulation Infection: A Large Case Series

Tolleson

Stroh

Ehrenfeld

et al. 2014

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) is a proven treatment for various movement disorders resistant to medical management. Complications such as postsurgical infection can negate benefits and increase patient morbidity. We sought to better define risk factors for infection. Methods: We performed a review of DBS cases at our institution from January 1996 to June 2011. Information on multiple metrics including surgical complications, procedural complications and infection were entered into a secure online database. Results: A total of 447 patients received DBS surgery. Twenty-six (5.82%) developed infection sometime after DBS surgery with 9 (2.01%) developing infection within 30 days after the final staged surgery. Operating surgeon (p = 0.012), scalp erosion (p = 0.0001), surgical incision opening time (0.0001) and number of individuals in the operating room (0.0027) were significant in the cumulative infection group. Conclusion: The 30-day infection rate was comparably low to other published studies. Several factors were noted to be significant in the cumulative infection group, but none in the 30-day infection group. Further understanding of infection risk factors is important to optimize patient selection and standardize infection-preventative techniques.

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“…Although much of the data is limited by its retrospective and non-randomized design, the success of some of these strategies has been quite impressive. Halpern et al [7] reported that self-administered pre-operative alcohol-based antiseptic wash reduced DBS infection from 9.02% to 0% in their center. Miller et al [8] demonstrate that local neomycin/polymyxin antibiotic significantly reduced infections when applied locally in the surgical sites of patients undergoing stereotactic and functional neurosurgical hardware operations.…”

Section: Strategies For Infection Prevention In Neuromodulationmentioning

confidence: 99%

Prevention of Implant-Associated Infection in Neuromodulation: Review of the Literature and Prototype of a Novel Protective Implant Coating

Tomycz

Payne

Cheng

et al. 2020

Surgical Infections

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Background: Implanting hardware into surgical sites increases the rate of infection associated with these sites. Without novel efforts to reduce this rate of infection, we can expect to see an increase in the number of hardware-associated infections as more patients are implanted with these devices. These infections often necessitate the removal of these devices resulting in a significant financial and clinical burden to patients. We developed a prototype antibiotic coating using products that are both low cost and that can be sourced easily. Our study aims to test the effectiveness of this coating against bacteria commonly observed in hospitalassociated infections. Methods: The antibiotic coating was prepared by combining one gram of vancomycin and 500 mg of ciprofloxacin in 50 mL of glycerol. The coating was examined for inhibition of growth of Pseudomonas aeruginosa PA14 and Staphylococcus aureus AH2486 and compared with the bacterial growth of the above bacteria in glycerol alone. The growth curves were plotted measuring the bacterial growth at 5 h intervals. Results: The results of the growth curves clearly demonstrate a lack of bacterial growth when these bacteria are combined with glycerol combined with our selected antibiotic agents. Conclusion: There appears to be a limited interest from device companies in developing new strategies for infection prevention associated with neurosurgical hardware, and we propose that this prototype will be an effective and low-cost solution to a large problem.

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Self-administered preoperative antiseptic wash to prevent postoperative infection after deep brain stimulation

Cited by 19 publications

References 10 publications

The Risk of Hardware Infection in Deep Brain Stimulation Surgery Is Greater at Impulse Generator Replacement than at the Primary Procedure

The Risk of Hardware Infection in Deep Brain Stimulation Surgery Is Greater at Impulse Generator Replacement than at the Primary Procedure

The Factors Involved in Deep Brain Stimulation Infection: A Large Case Series

Prevention of Implant-Associated Infection in Neuromodulation: Review of the Literature and Prototype of a Novel Protective Implant Coating

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