Cerebrospinal fluid shunt operations without cranial bandaging. Clinical article.
OBJECTIVE
Cranial bandages are commonly applied over scalp incisions immediately after cerebrospinal fluid (CSF) shunt surgery, putatively to prevent complications, particularly infection. These bandages require resources, consume the time of healthcare workers, and incur non-negligible expenses. It is therefore both reasonable and important to examine the efficacy of cranial bandaging.


METHODS
The combined experience of 3 neurosurgeons over 6.75 years with using no cranial bandaging after operations for implantation or revision of CSF shunts is the basis of this report. These data were prospectively accrued and retrospectively analyzed.


RESULTS
The infection rate was 4.2% (95% CI 3.1-5.6%) for 1064 operations performed without postoperative cranial bandaging after either shunt insertion or revision surgery through clean or clean-contaminated wounds. The age distribution extended from premature infants through adults 77 years of age.


CONCLUSIONS
The results of this investigation support the position that bandaging scalp wounds after CSF shunt implantation or revision surgery adds no benefit beyond the easier, simpler, faster, and cheaper practice of using antibiotic ointment as a dressing without bandaging.
Winston
Ken R
KR
Department of Neurosurgery of The University of Colorado Denver School of Medicine, The Children's Hospital and Denver Health Medical Center, Denver, Colorado, USA. winston.ken@tchden.org
Trinidad
Elizabeth
E
Wilkinson
C Corbett
CC
McBride
Lori A
LA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001458:Bandages; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009824:Ointments; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control
D000900:Anti-Bacterial Agents; D009824:Ointments