title: Bandages, dressings, and cranial neurosurgery.
abstract: OBJECTIVE
  Bandages and dressings are commonly applied to incisional scalp wounds to prevent complications, particularly infection, during the early stages of wound healing. Bandaging cranial incisional wounds requires resources, consumes healthcare workers' time, and incurs expense; it is therefore important to examine its efficacy.
  
  
  METHODS
  All cranial operations (excluding shunt placements, procedures on the scalp alone, and bur hole procedures) performed between June 30, 2001 and January 1, 2006, by two neurosurgeons at either of two hospitals, one adult and one pediatric institution, were reviewed. Surgical site infections (SSIs) and other postoperative complications were investigated with respect to the use of bandaging for incisional wounds and other aspects of postoperative wound management. The operations were classified into four categories based on wound type: "clean," "clean-contaminated," "contaminated," and "dirty," according to the criteria of the Centers for Disease Control and Prevention.
  
  
  CONCLUSIONS
  A total of 702 operations were performed in 577 patients; only five patients received any type of surgical bandaging. There were four SSIs (0.57%; 95% confidence interval [CI] 0.16-1.45). The postoperative infection rate in the 626 clean cases was 0.48% (95% CI 0.10-1.39) and was 2.63% (95% CI 0.07-13.81) in the 38 clean-contaminated cases. The data obtained in this investigation is consistent with the position that bandaging incisional scalp wounds after cranial surgery adds little if any benefit beyond the easier, simpler, and cheaper practice of using antibiotic ointment as a dressing without bandaging.
authors.affiliation: Department of Neurosurgery, The University of Colorado Health Sciences Center, The Children's Hospital, Denver, Colorado, USA. winston.ken@tchden.org
authors.forename: Ken R
authors.initials: KR
authors.lastname: Winston
authors.forename: Lori A
authors.initials: LA
authors.lastname: McBride
authors.forename: Anwar
authors.initials: A
authors.lastname: Dudekula
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012535:Scalp; D012886:Skull / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*