title: When should ventriculoperitoneal shunt placement be performed in cases with myelomeningocele and hydrocephalus?
abstract: OBJECTIVE
  The shunt infection rates vary from 2 to 39% among complications related to shunts used for hydrocephalus treatment. Shunt infections are reported to be more common than any other etiologies in newborn babies with myelomeningocele.
  
  
  METHODS
  In this study, we performed a retrospective evaluation of 94 MM and HS cases that were treated in our clinics between 1994 and 2005. Comparisons of shunt infection rates of cases that had surgical placement of VPS either at a different session (group A) or in the same session (Group B) with repair of MM sac were made.
  
  
  RESULTS
  Sixty three patients were grouped in group A and 31 cases in group B. MM sac operation site wound infection was seen in 7 versus 5 cases, CSF fistula in 5 versus 3 cases and VPS infection in 9 versus 6 cases in group A and B respectively. 6 patients had meningitis in both groups.
  
  
  CONCLUSIONS
  These data indicate that ventriculoperitoneal shunt placement in the same session of MM sac repair in patients with HS is not an acceptable practice. We therefore believe in VPS placement in a separate session by confirming absence of infection after MM sac repair surgery.
authors.affiliation: Erciyes University Medical Faculty, Neurosurgery, Kayseri, Turkey. oktemis@erciyes.edu.tr
authors.forename: Ibrahim Suat
authors.initials: IS
authors.lastname: Oktem
authors.forename: Ahmet
authors.initials: A
authors.lastname: Menkü
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Ozdemir
mesh_terms: D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000150:complications; D008591:Meningomyelocele / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D016459:Prosthesis-Related Infections / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D013530:Surgical Wound Infection / Q000453:epidemiology; D017287:Ventriculoperitoneal Shunt / Q000009:adverse effects*