title: Effect of an intraoperative double-gloving strategy on the incidence of cerebrospinal fluid shunt infection.
abstract: OBJECTIVE
  The purpose of this study was to determine the effect of double gloving on cerebrospinal fluid (CSF) shunt infection rates.
  
  
  METHODS
  Data obtained in two large groups of patients, one in which the surgical personnel wore a single pair of gloves each and the other in which the personnel wore two pairs of gloves each, were retrospectively studied. The study involved 863 patients. The overall infection rate in the single-gloved group was 15.2%, whereas it was 6.7% in the double-gloved group (p = 0.0002). Of additional interest was the marked difference between the overall shunt infection rates in younger children (< 11.3 years of age; 15.7%) and older children (> 11.3 years of age) and adults (6.7%; p < 0.00005).
  
  
  CONCLUSIONS
  The strategy of wearing two pairs of gloves while performing surgery appears to reduce the incidence of postoperative shunt infection by more than 50%. The incidence of shunt infection is highly age dependent. The shunt infection rate may be further reduced by carefully studying the individual variables associated with the shunt insertion procedure.
authors.affiliation: Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232-2380, USA. noel.tulipan@vanderbilt.edu
authors.forename: Noel
authors.initials: N
authors.lastname: Tulipan
authors.forename: Mario A
authors.initials: MA
authors.lastname: Cleves
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005932:Gloves, Surgical; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007432:Intraoperative Period; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*