Literature DB >> 33930864

Are preoperative chlorhexidine gluconate showers associated with a reduction in surgical site infection following craniotomy? A retrospective cohort analysis of 3126 surgical procedures.

Simon G Ammanuel1, Caleb S Edwards1, Andrew K Chan1, Praveen V Mummaneni1, Joseph Kidane1, Enrique Vargas1, Sarah D'Souza1, Amy D Nichols2, Sujatha Sankaran3, Adib A Abla1, Manish K Aghi1, Edward F Chang1, Shawn L Hervey-Jumper1, Sandeep Kunwar1, Paul S Larson1, Michael T Lawton1, Philip A Starr1, Philip V Theodosopoulos1, Mitchel S Berger1, Michael W McDermott1.   

Abstract

OBJECTIVE: Surgical site infection (SSI) is a complication linked to increased costs and length of hospital stay. Prevention of SSI is important to reduce its burden on individual patients and the healthcare system. The authors aimed to assess the efficacy of preoperative chlorhexidine gluconate (CHG) showers on SSI rates following cranial surgery.
METHODS: In November 2013, a preoperative CHG shower protocol was implemented at the authors' institution. A total of 3126 surgical procedures were analyzed, encompassing a time frame from April 2012 to April 2016. Cohorts before and after implementation of the CHG shower protocol were evaluated for differences in SSI rates.
RESULTS: The overall SSI rate was 0.6%. No significant differences (p = 0.11) were observed between the rate of SSI of the 892 patients in the preimplementation cohort (0.2%) and that of the 2234 patients in the postimplementation cohort (0.8%). Following multivariable analysis, implementation of preoperative CHG showers was not associated with decreased SSI (adjusted OR 2.96, 95% CI 0.67-13.1; p = 0.15).
CONCLUSIONS: This is the largest study, according to sample size, to examine the association between CHG showers and SSI following craniotomy. CHG showers did not significantly alter the risk of SSI after a cranial procedure.

Entities:  

Keywords:  antisepsis; chlorhexidine; craniotomy; preoperative showers; surgical site infection

Year:  2021        PMID: 33930864      PMCID: PMC9448162          DOI: 10.3171/2020.10.JNS201255

Source DB:  PubMed          Journal:  J Neurosurg        ISSN: 0022-3085            Impact factor:   5.408


  41 in total

Review 1.  Preoperative chlorhexidine shower or bath for prevention of surgical site infection: a meta-analysis.

Authors:  Maciej Piotr Chlebicki; Nasia Safdar; John Charles O'Horo; Dennis G Maki
Journal:  Am J Infect Control       Date:  2012-06-19       Impact factor: 2.918

2.  Evidence for using chlorhexidine gluconate preoperative cleansing to reduce the risk of surgical site infection.

Authors:  Charles E Edmiston; Obi Okoli; Mary Beth Graham; Sharon Sinski; Gary R Seabrook
Journal:  AORN J       Date:  2010-11       Impact factor: 0.676

3.  In Reply: Chlorhexidine Showers Are Associated With a Reduction in Surgical Site Infection Following Spine Surgery: An Analysis of 4266 Consecutive Surgeries.

Authors:  Andrew K Chan; Praveen V Mummaneni
Journal:  Neurosurgery       Date:  2020-06-01       Impact factor: 4.654

Review 4.  Preoperative bathing or showering with skin antiseptics to prevent surgical site infection.

Authors:  Joan Webster; Sonya Osborne
Journal:  Cochrane Database Syst Rev       Date:  2015-02-20

5.  Advance pre-operative chlorhexidine reduces the incidence of surgical site infections in knee arthroplasty.

Authors:  Michael G Zywiel; Jacqueline A Daley; Ronald E Delanois; Qais Naziri; Aaron J Johnson; Michael A Mont
Journal:  Int Orthop       Date:  2010-06-20       Impact factor: 3.075

6.  Impact of resident involvement in neurosurgery: an analysis of 8748 patients from the 2011 American College of Surgeons National Surgical Quality Improvement Program database.

Authors:  Seokchun Lim; Andrew T Parsa; Bobby D Kim; Joshua M Rosenow; John Y S Kim
Journal:  J Neurosurg       Date:  2015-01-23       Impact factor: 5.115

7.  Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections.

Authors:  Ying Chen; Linyan Zhang; Tingting Qin; Zhenzhen Wang; Ying Li; Bing Gu
Journal:  Neurosurg Focus       Date:  2019-08-01       Impact factor: 4.047

8.  Risk factors for unplanned readmission within 30 days after pediatric neurosurgery: a nationwide analysis of 9799 procedures from the American College of Surgeons National Surgical Quality Improvement Program.

Authors:  Brandon A Sherrod; James M Johnston; Brandon G Rocque
Journal:  J Neurosurg Pediatr       Date:  2016-05-17       Impact factor: 2.375

Review 9.  Staphylococcus aureus and surgical site infections: benefits of screening and decolonization before surgery.

Authors:  H Humphreys; K Becker; P M Dohmen; N Petrosillo; M Spencer; M van Rijen; A Wechsler-Fördös; M Pujol; A Dubouix; J Garau
Journal:  J Hosp Infect       Date:  2016-06-18       Impact factor: 3.926

10.  Chlorhexidine Showers are Associated With a Reduction in Surgical Site Infection Following Spine Surgery: An Analysis of 4266 Consecutive Surgeries.

Authors:  Andrew K Chan; Simon G Ammanuel; Alvin Y Chan; Taemin Oh; Henry C Skrehot; Caleb S Edwards; Sravani Kondapavulur; Catherine A Miller; Amy D Nichols; Catherine Liu; Sanjay S Dhall; Aaron J Clark; Dean Chou; Christopher P Ames; Praveen V Mummaneni
Journal:  Neurosurgery       Date:  2019-12-01       Impact factor: 4.654

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