Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection
Introduction Causation of surgical site infection (SSI) following craniotomy is multifactorial. Most preventive strategies (including site preparation and antibiotic prophylaxis) revolve around reducing preoperative contamination of the local site. There is little evidence, however, linking site con...
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| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2012-01-01
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| Series: | Indian Journal of Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.94367 |
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| author | Aliasgar V. Moiyadi Umesh Sumukhi Prakash M. Shetty Sanjay Biswas Rohini S. Kelkar |
| author_facet | Aliasgar V. Moiyadi Umesh Sumukhi Prakash M. Shetty Sanjay Biswas Rohini S. Kelkar |
| author_sort | Aliasgar V. Moiyadi |
| collection | DOAJ |
| description | Introduction
Causation of surgical site infection (SSI) following craniotomy is multifactorial. Most preventive strategies (including site preparation and antibiotic prophylaxis) revolve around reducing preoperative contamination of the local site. There is little evidence, however, linking site contamination with postoperative infections. This is important given the preference for performing non-shaved cranial surgery. We undertook a prospective study to document the scalp flora in neurosurgical patients in an Indian setting and to assess possible association with SSI.
Materials and Methods
A prospective study recruited 45 patients undergoing non-shaved clean craniotomies for various brain tumors. Standard perioperative procedures and antibiotic policy were employed. Prior to and immediately following the pre-surgical scrubbing, we collected swabs and evaluated their growth qualitatively. SSI was documented adhering to CDC guidelines. The association of swab-positivity with various parameters (including SSI) was evaluated.
Results
Pre-scrub positivity was seen in 18 of 44 patients, three of them developed subsequent SSI. Most were known skin contaminants. Five patients had swab positivity after scrubbing, though none of these developed any SSI. Four of these five had pre-scrub positivity. In three the same organisms persisted (two being Staphylococcus aureus), and one had different growth post-scrub, whereas one patient developed new growth (contaminant mycelial fungus) in the post-scrub swab. We did not find any association between swab positivity and SSI. Swab positivity was also not related to hair-length or hygiene.
Conclusion
Scalp flora in Indian patients is similar to that described. Pre-surgical preparation does not always eliminate this contamination (especially staphylococcus). However, this does not necessarily translate into increased SSI. Moreover, the results also provide objective evidence to support the performance of non-shaved cranial surgery without an undue risk of SSI. |
| format | Article |
| id | doaj-art-e174ead47c8f43c4a50ea08be8a3d56d |
| institution | OA Journals |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-e174ead47c8f43c4a50ea08be8a3d56d2025-08-20T02:21:38ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672012-01-01010102803210.4103/2277-9167.94367Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infectionAliasgar V. MoiyadiUmesh Sumukhi0Prakash M. ShettySanjay Biswas1Rohini S. Kelkar2Microbiology, Neurosurgery ServicesMicrobiology, Neurosurgery ServicesMicrobiology, Neurosurgery ServicesIntroduction Causation of surgical site infection (SSI) following craniotomy is multifactorial. Most preventive strategies (including site preparation and antibiotic prophylaxis) revolve around reducing preoperative contamination of the local site. There is little evidence, however, linking site contamination with postoperative infections. This is important given the preference for performing non-shaved cranial surgery. We undertook a prospective study to document the scalp flora in neurosurgical patients in an Indian setting and to assess possible association with SSI. Materials and Methods A prospective study recruited 45 patients undergoing non-shaved clean craniotomies for various brain tumors. Standard perioperative procedures and antibiotic policy were employed. Prior to and immediately following the pre-surgical scrubbing, we collected swabs and evaluated their growth qualitatively. SSI was documented adhering to CDC guidelines. The association of swab-positivity with various parameters (including SSI) was evaluated. Results Pre-scrub positivity was seen in 18 of 44 patients, three of them developed subsequent SSI. Most were known skin contaminants. Five patients had swab positivity after scrubbing, though none of these developed any SSI. Four of these five had pre-scrub positivity. In three the same organisms persisted (two being Staphylococcus aureus), and one had different growth post-scrub, whereas one patient developed new growth (contaminant mycelial fungus) in the post-scrub swab. We did not find any association between swab positivity and SSI. Swab positivity was also not related to hair-length or hygiene. Conclusion Scalp flora in Indian patients is similar to that described. Pre-surgical preparation does not always eliminate this contamination (especially staphylococcus). However, this does not necessarily translate into increased SSI. Moreover, the results also provide objective evidence to support the performance of non-shaved cranial surgery without an undue risk of SSI.http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.94367non-shaved neurosurgerypreoperative preparationpostcraniotomy infectionscalp flora |
| spellingShingle | Aliasgar V. Moiyadi Umesh Sumukhi Prakash M. Shetty Sanjay Biswas Rohini S. Kelkar Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection Indian Journal of Neurosurgery non-shaved neurosurgery preoperative preparation postcraniotomy infection scalp flora |
| title | Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection |
| title_full | Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection |
| title_fullStr | Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection |
| title_full_unstemmed | Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection |
| title_short | Scalp flora in Indian patients undergoing craniotomy for brain tumors – Implications for pre-surgical site preparation and surgical site infection |
| title_sort | scalp flora in indian patients undergoing craniotomy for brain tumors implications for pre surgical site preparation and surgical site infection |
| topic | non-shaved neurosurgery preoperative preparation postcraniotomy infection scalp flora |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.94367 |
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