Nonshaved ventriculoperitoneal shunt in Thailand

Ratanalert, Sanguansin; Musikawat, Paphan; Oearsakul, Thakul; Saeheng, Sakchai; Chowchuvech, Vorapong

doi:10.1016/j.jocn.2004.03.024

Cited by 20 publications

(17 citation statements)

References 16 publications

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“…1). 1,[3][4][5][7][8][9][11][12][13][14][16][17][18][19][20][23][24][25]27,28 Two of these studies were RCTs (Level I evi dence). 5,8 A short overview of the included articles is pre sented in Tables 1-3, describing the following aspects: lev el of evidence; number of patients included; perioperative management regarding shampooing, disinfection, shaving, and antibiotics; and infection rates.…”

Section: Resultsmentioning

confidence: 99%

“…This appeared to be slightly lower than in the retrospectively studied shaved control group (7%). Ratanalert et al 18 observed a greater differ ence in infection rate between the unshaved group (6%, 2 of 32 patients) and the shaved group (15%, 13 of 87 patients).…”

Section: Shunt Implantations or Csf Diversionmentioning

confidence: 93%

“…1,3,4,9,11,14,[16][17][18][23][24][25]27,28 The first group to study the effect of preoperative shaving in shunt placement reported 6 wound infections in 218 CSF diversions (3%). Of these 6 infections, 1 was not related to the shaveless policy, but to erosion of hard ware through the overlying scalp.…”

Section: Shunt Implantations or Csf Diversionmentioning

confidence: 99%

“…1,3,9,13,16,18,24,25,28 Two publications were restricted to describe the effect of preoperative shaving in the pediat ric neurosurgical population only. 16,25 Piatt and Steinbok 16 performed 168 pediatric neurosurgical procedures: 120 patients were not shaved preoperatively, and 48 under went clipping of a narrow strip of hair.…”

Section: Various Subgroupsmentioning

confidence: 99%

“…All 3 shunt infections occurred in children younger than 6 months. Ratanalert et al 18 made a distinction in their study between patients younger than 12 months and those who were older. For patients younger than 12 months, in the shaved group (29 cases), 4 infections (14%) were observed, which is comparable to the 2 infections (22%) that were observed in the group that was not shaved preoperatively (9 cases).…”

Section: Various Subgroupsmentioning

confidence: 99%

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Neurosurgery and shaving: what's the evidence?

Broekman

Beijnum

Peul

et al. 2011

JNS

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M ost patients undergoing neurosurgical proce dures dread the commonly performed preopera tive hair removal. Nevertheless, many neuro surgeons insist on removing the patient's hair before sur gery. They claim that this routine prevents postoperative infections and decreases the risk of overlooking wounds or lacerations after head trauma. Moreover, they argue that preoperative hair removal facilitates accurate plan ning of the incision, attachment and/or removal of the drapes, and closure of the wound.However, since the 1980s several reports have been published indicating that preoperative shaving may in crease the risk of postoperative infections due to a change or loss of protective skin flora and/or bacterial coloniza tion of the shaved area caused by the razor-induced mi crotrauma. 21,22,28 We systematically reviewed the current literature on preoperative shaving before neurosurgical procedures, and in this study we discuss the role of shaving preced ing craniotomies, bur hole procedures, spine surgery, and implantation surgery in both adults and children. Methods Literature Search StrategyTwo reviewers (M.L.D.B. and J.v.B.) searched Pub Med, Embase, and the Cochrane Database of Systematic Reviews up to September 8, 2009, using an electronic search strategy ([ OR ] AND [ OR ]) supple mented by hand searching the bibliographies of articles re trieved by the electronic search. We restricted this review to published data. Only papers written in English, Dutch, French, or German were considered for this review. Titles and abstracts of retrieved citations were screened, and po tentially suitable studies were read in full by both review ers. Relevant data were extracted and disagreements were resolved by discussion. The following inclusion criteria were used: 1) studies reporting on consecutive patient se ries in which either one predefined preoperative shaving policy was used or in which different policies were com pared; and 2) studies describing postoperative wound in fections and other serious (infectious) complications. Critical AppraisalThe authors aimed for a critical appraisal of the ar ticles guided by a simplified classification regarding level Department of Neurosurgery, Leiden University Medical Center, Leiden, The NetherlandsMany neurosurgeons remove their patients' hair before surgery. They claim that this practice reduces the chance of postoperative surgical site infections, and facilitates planning, attachment of the drapes, and closure. However, most patients dread this procedure. The authors performed the first systematic review on shaving before neurosurgical procedures to investigate whether this commonly performed procedure is based on evidence. They systematically re viewed the literature on wound infections following different shaving strategies. Data on the type of surgery, surgery related infections, preoperative shaving policy, decontamination protocols, and perioperative antibiotics protocols were collected. The search dete...

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Section: Resultsmentioning

confidence: 99%

Section: Shunt Implantations or Csf Diversionmentioning

confidence: 93%

Section: Shunt Implantations or Csf Diversionmentioning

confidence: 99%

Section: Various Subgroupsmentioning

confidence: 99%

Section: Various Subgroupsmentioning

confidence: 99%

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Neurosurgery and shaving: what's the evidence?

Broekman

Beijnum

Peul

et al. 2011

JNS

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Preoperative hair removal to reduce surgical site infection

Tanner

Norrie²,

Melen

2011

Cochrane Database of Systematic Reviews

211

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Whilst this review found no statistically significant effect on SSI rates of hair removal insufficient numbers of people have been involved in this research to allow confidence in a conclusion. When it is necessary to remove hair, the existing evidence suggests that clippers are associated with fewer SSIs than razors. There was no significant difference in SSI rates between depilatory creams and shaving, or between shaving or clipping the day before surgery or on the day of surgery however studies were small and more research is needed.

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