Open AccessCSF SHUNT INFECTION;
Author(s) -
Muhammad Sohaib Anwer,
Muhammad Waqas,
Ameer Khan
Publication year - 2017
Publication title -
the professional medical journal/the professional medical journal
Language(s) - English
Resource type - Journals
eISSN - 2071-7733
pISSN - 1024-8919
DOI - 10.29309/tpmj/2017.24.01.420
Subject(s) - medicine , hydrocephalus , shunt (medical) , shunting , neurosurgery , surgery , population , environmental health
Hydrocephalus is the abnormal accumulation of CSF with in the ventricles andsubarachnoid spaces. It is often associated with dilatation of ventricular system and increasedICP. Hydrocephalus is almost always a result of an interruption of CSF flow and rarely becauseof increased CSF production. The definitive treatment of hydrocephalus is surgical treatmentwhich includes shunting and non-shunting procedures. The most common and overwhelmingcomplications that can occur due to the CSF shunts is infection. The risk factors associated withpediatric CSF shunt infection has been analyzed in this study. Study Design: Descriptive study.Setting: Department of Neurosurgery, Nishtar Hospital Multan & Sheikh Zayed Hospital RahimYar Khan. Period: Three years 01-07-2013 to 01-07-2016. Method: Total 209 eligible patientswho were operated for CSF shunt were keenly monitored. Several variables were observedand the responses against these variables were noted down. Post operative follow up of allthese cases done for 6 months in order to notice any development of infection (clinical signsof infection & CSF examination) in CSF shunt system. Chi-square method was used appliedin order to analyze the association among the variables and shunt infection development.Inour population of 209 patients only twenty six patients (12.44%) suffered from shunt infection.In this study four variables were qualified as having significant association with greater risk ofshunt infection. 1) Patient age. 2) Inadvertently exposure of surgical instruments to the shuntsystem. 3) the existence of large number of previous shunt systems. 4) manual handling ofshunt system Conclusions: Four variables have been reported by this study which can be agreat source of shunt infection.it is recommended that changes in clinical practice should beconsidered in order to avoid these. Few recommendations are as follows. 1) While handling theshunt system great care should be taken. 2) It should be taken care that the manual contactof the Surgeons with the shunt system should be minimum. 3) it is recommended that thealternatives other then the shunt insertion should be considered especially for the children. 4)Great number of previous shunt system is also a great risk factor and these patients must behandled as individuals at high risk.