title: The factors involved in deep brain stimulation infection: a large case series.
abstract: BACKGROUND
  Deep brain stimulation (DBS) is a proven treatment for various movement disorders resistant to medical management. Complications such as postsurgical infection can negate benefits and increase patient morbidity. We sought to better define risk factors for infection.
  
  
  METHODS
  We performed a review of DBS cases at our institution from January 1996 to June 2011. Information on multiple metrics including surgical complications, procedural complications and infection were entered into a secure online database.
  
  
  RESULTS
  A total of 447 patients received DBS surgery. Twenty-six (5.82%) developed infection sometime after DBS surgery with 9 (2.01%) developing infection within 30 days after the final staged surgery. Operating surgeon (p = 0.012), scalp erosion (p = 0.0001), surgical incision opening time (0.0001) and number of individuals in the operating room (0.0027) were significant in the cumulative infection group.
  
  
  CONCLUSIONS
  The 30-day infection rate was comparably low to other published studies. Several factors were noted to be significant in the cumulative infection group, but none in the 30-day infection group. Further understanding of infection risk factors is important to optimize patient selection and standardize infection-preventative techniques.
authors.affiliation: Vanderbilt University Hospital, Nashville, Tenn., USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Tolleson
authors.forename: Jessica
authors.initials: J
authors.lastname: Stroh
authors.forename: Jesse
authors.initials: J
authors.lastname: Ehrenfeld
authors.forename: Joseph
authors.initials: J
authors.lastname: Neimat
authors.forename: Peter
authors.initials: P
authors.lastname: Konrad
authors.forename: Fenna
authors.initials: F
authors.lastname: Phibbs
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local; D019072:Antibiotic Prophylaxis; D002710:Chlorhexidine / Q000031:analogs & derivatives; D015897:Comorbidity; D046690:Deep Brain Stimulation / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011184:Postoperative Period; D011206:Povidone-Iodine; D012189:Retrospective Studies; D012307:Risk Factors; D012871:Skin Diseases / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D058106:Wound Closure Techniques / Q000009:adverse effects
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine