SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2015
Evidence-based interventions to reduce shunt infections: a systematic review.
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Open versus laparoscopic ventriculoperitoneal shunt placement in children: a systematic review and meta-analysis.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Pooled it
- Survival outcomes and risk factors for ventriculo-peritoneal shunt failure in pediatric hydrocephalus: a multi-center cohort study in Vietnam.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Ventriculoperitoneal shunt failures at Red Cross War Memorial Children's Hospital.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Healthcare-Associated Ventriculitis in Children during COVID-19 Pandemic: Clinical Characteristics and Outcome of a First Infection.Antibiotics (Basel, Switzerland) · 2023Article
- Reducing ventriculoperitoneal shunt infection with intraoperative glove removal.Infection control and hospital epidemiology · 2023Article
- Effect of tetracycline hydrochloride application on dental pulp stem cell metabolism-booster or obstacle for tissue engineering?Frontiers in pharmacology · 2023Article
- Surgical Applications of Materials Engineered with Antimicrobial Properties.Bioengineering (Basel, Switzerland) · 2022Review
- Ventriculoperitoneal Shunt without Hair Shaving Using Absorbable Suture Materials.Journal of Korean Neurosurgical Society · 2021Article
- Neurosurgical Post-Operative Wound Infections: A retrospective study on surgical site infections for quality improvement.International wound journal · 2020Article
- Towards zero infection for ventriculoperitoneal shunt insertion in resource-limited settings: a multicenter prospective cohort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
- Shunt infections: a review and analysis of a personal series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2018Review
- Topical vancomycin reduces the cerebrospinal fluid shunt infection rate: A retrospective cohort study.PloS one · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCerebrospinal fluid shunt infection is associated with patient morbidity and high cost. We conducted a systematic review of the current evidence of comprehensive surgical protocols or individual interventions designed to reduce shunt infection incidence.
methodsA systematic review using PubMed and SCOPUS identified studies evaluating the effect of a particular intervention on shunt infection risk. Systemic prophylactic antibiotic or antibiotic-impregnated shunt efficacy studies were excluded. A total of 7429 articles were screened and 23 articles were included.
resultsEight studies evaluated the effect of comprehensive surgical protocols. Shunt infection was reduced in all studies (absolute risk reduction 2.2-12.3 %). Level of evidence was low (level 4 in seven studies) due to the use of historical controls. Compliance ranged from 24.6 to 74.5 %. Surgical scrub with antiseptic foam and omission of a 5 % chlorhexidine gluconate preoperative hair wash were both associated with increased shunt infection. Twelve studies evaluated the effect of a single intervention. Only antibiotic-impregnated suture, a no-shave policy, and double gloving with glove change prior to shunt handling, were associated with a significant reduction in shunt infection. In a hospital with high methicillin-resistant staphylococcus aureus (MRSA) prevalence, a randomized controlled trial found that perioperative vancomycin rather than cefazolin significantly reduced shunt infection rates.
conclusionDespite wide variation in compliance rates, the implementation of comprehensive surgical protocols reduced shunt infection in all published studies. Antibiotic-impregnated suture, a no-shave policy, double gloving with glove change prior to device manipulation, and 5 % chlorhexidine hair wash were associated with significant reductions in shunt infection.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.