title: Risk factors for postcraniotomy surgical site infection after 1,3-bis (2-chloroethyl)-1-nitrosourea (Gliadel) wafer placement.
abstract: Gliadel wafers (1,3-bis [2-chloroethyl]-1-nitrosourea; Guilford Pharmaceuticals) are approved for the treatment of malignant gliomas; however, the incidence of and risk factors associated with infection with respect to this new technology are unknown. We identified 32 patients who received Gliadel wafers from December 1996 through October 1999. Nine patients (28%) developed >or=1 surgical site infection (SSI), which included 4 cases of brain abscess. All 3 patients who received vancomycin for surgical prophylaxis developed an SSI. In addition, multivariable analysis revealed an association between infection and a clinical diagnosis of depression. The National Nosocomial Infection Surveillance Surgical Site Index did not predict the onset of SSI after Gliadel wafer implantation. Patients who received a Gliadel wafer had a higher incidence of infection than previously has been reported, and additional studies are required to better quantify this risk and describe the epidemiology of such infections.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, USA. paul.mcgovern@uphs.upenn.edu
authors.forename: Paul C
authors.initials: PC
authors.lastname: McGovern
authors.forename: Ebbing
authors.initials: E
authors.lastname: Lautenbach
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Brennan
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lustig
authors.forename: Neil O
authors.initials: NO
authors.lastname: Fishman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004343:Drug Implants / Q000009:adverse effects*; D005910:Glioma / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors
chemical_list: D004343:Drug Implants