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Reduction of Surgical-site Infections in Neurosurgery
improved by the production of a sterile surface. The risk of surgical- sizes become too large for such a study and the decision to use a
site infection is proportional to the number of residual bacteria at the given agent must rest on other information.
wound site, so a reduction in skin bacterial density will be associated
with a concomitant reduction in surgical-site infection. In any The cumulative in vitro and in vivo evidence related to wound
situation, a randomised prospective clinical study generally carries contamination and extensive clinical experience with implanted
the highest evidence of proof of efficacy of a given treatment neurosurgical devices illustrate the utility of using 3M™Ioban™2 as
regimen. However, in the presence of low infection rates, sample part of an infection prevention regimen within neurosurgery. n
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Am J Infect Control, 2005;33(5):292–8. 1999;43:5–11. 27. Mack D, Molecular mechanisms of Staphylococcus
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prevention of surgical site infections, Surgeon, 2009;7(3): dysfunction in the capacity of rabbit alveolar S113–25.
170–72. macrophages to kill Staphylococcus epidermidis RP12, 28. Habash M, Reid G, Microbial biofilms: their development
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prophylaxis, Surgery, 2003;134:S10–S17. Nosocomially acquired Pseudomonas stutzeri brain San Diego, California.
6. Larson E, McGinley K, Foglia A, et al., Composition and abscess in a child: case report and review, Infect Contol 30. ASTM Standard Guide for Assessment of Antimicrobial
antimicrobic resistance of skin flora in hospitalized and Hosp Epidemiol, 2006;27(6):630–32. Activity Using a Time-Kill Procedure, E2315-03, West
healthy adults, J Clin Microbiol, 1986;23(3):604–8. 20. Ratilal B, Costa J, Sampaio C, Antibiotic prophylaxis for Conshohocken, PA, ASTM International, 2008.
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8. Milstone AM, Passaretti CL, Perl TM, Chlorhexidine: impregnated shunts in hydrocephalus therapy reduce the 32. Lewis DA, Leaper DJ, Speller DC, Prevention of bacterial
expanding the armamentarium for infection control and risk of infection? An observational study in 258 patients, colonization of wounds at operation: comparison of iodine
prevention, Clin Infect Dis, 2008;46:274–81. BMC Infect Dis, 2007;7:38. impregnated (‘Ioban’) drapes with conventional methods,
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disease, Infect Control Hosp Epidemiol, 1996;17(8):521–8. cerebrospinal fluid shunts in infants: a study of etiological 33. Tentative Final Monograph for Healthcare Antiseptic Drug
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Surg Infections, 2006;7(Suppl. 1):S13–S17. wound contamination by skin organisms by the prosthetic hip infection at revision arthroplasty by
11. Mangram AJ, Horan TC, Pearson ML, et al., Guideline for preoperative application of an iodophor impregnated immunofluorescence microscopy and PCR amplification
prevention of surgical site infection, 1999, Am J Infect plastic adhesive drape, J Int Med Res, 1986;14:105–9. of the bacterial 16S rRNA gene, J Clin Microbiol, 1999;37(10):
Control, 1999;27(2):97–132. 24. Jacobson C, Osmon D, Hanssen A, et al., Prevention of 3281–90.
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removal to reduce surgical site infection (Review), Cochrane 2 drapes, Clin Orthop Relat Res, 2005;439:32–7. detection of infection in hip replacements. A currently
Database Syst Rev, 2009;CD004122(3). 25. Parks PJ, The roles of individual variation and sebum underestimated problem, J Bone Joint Surg Br, 2002;80(4):
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cases, Neurosurgery, 1994;34(3):409–15. (SHEA), 5–8 April 2008, Orlando, Florida, 2008. year prospective study on microbial ecology of explanted
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to ventriculojugular shunts, Biomater Med Devices Artif Organs, Staphylococcus epidermidis polysaccharide intercellular joint loosening, Eur J Clin Microbiol Infect Dis, 1996;15(2):
1981;9:97–106. adhesin/hemagglutinin in the pathogenesis of 160–65.
EUROPEAN NEUROLOGICAL REVIEW 119
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