title: Self-administered preoperative antiseptic wash to prevent postoperative infection after deep brain stimulation.
abstract: BACKGROUND
  Prevention of surgical site infections is critical in deep brain stimulation (DBS). In the present study, we tested the ability of a self-administered preoperative alcohol-based (70% ethyl alcohol) preparation to reduce the rate of postoperative infection after DBS surgery.
  
  
  METHODS
  This Institutional Review Board-approved retrospective review was conducted at our institution between January 2005 and October 2007 (mean follow-up, 23 months). The participants comprised a consecutive sample of 172 patients with movement disorders who underwent DBS surgery at our institution. Starting in January 2007, all patients were required to use the alcohol-based preparation. These patients (n = 48) were instructed to self-administer the wash on the night before surgery and the morning of surgery. Before this time, no self-administered wash was used (n = 122).
  
  
  RESULTS
  There was no difference in preoperative skin cleansing between the 2 groups, and all patients received intravenous antibiotics immediately before and after surgery for 24 hours. We compared the rate of postoperative infection in the 2 groups and reviewed other possible factors underlying infection. We found 11 cases of infection (6.47%), all in the group without the preoperative antiseptic wash. The infection rate was 9.02% in the group without the preoperative wash and 0 in the group with the preoperative wash (P < .029). There was no difference between the 2 groups in terms of mean age, duration of operative procedure, or number of microelectrode tracts attempted.
  
  
  CONCLUSIONS
  Our results support the incorporation of this self-administered antiseptic wash into our standard antiseptic protocol for patients undergoing DBS surgery.
authors: Department of Neurosurgery, Center for Functional and Restorative Neurosurgery, University of Pennsylvania, Pennsylvania Hospital, Philadelphia, PA 19104, USA. Casey.Halpern@uphs.upenn.edu
authors: Casey H
authors: CH
authors: Halpern
authors: Grant W
authors: GW
authors: Mitchell
authors: Aaron
authors: A
authors: Paul
authors: Daniel R
authors: DR
authors: Kramer
authors: Kathryn R
authors: KR
authors: McGill
authors: Dana
authors: D
authors: Buonacuore
authors: Marie
authors: M
authors: Kerr
authors: Jurg L
authors: JL
authors: Jaggi
authors: John J
authors: JJ
authors: Stern
authors: Gordon H
authors: GH
authors: Baltuch
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012646:Self Administration / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local