Antimicrobial sutures reduce infections in brain shunt surgery, study finds

Jul 25, 2008

Children born with hydrocephalus, or "water on the brain" must have shunts implanted to drain the fluid away from the brain to reduce harmful pressure.

While shunts do their job well, the rate of shunt infection in children is very high for a variety of reasons, which requires putting the child through another surgery to replace the shunt, bringing with it more hospital time, potential additional neurological complications and an increased risk of death.

Now a new trial conducted by faculty at the University at Buffalo has shown that using antimicrobial sutures to secure the shunt and close the wound significantly reduces the number of shunt infections arising during the first six months after surgery.

Results of the trial appear online in the Journal of Neurosurgery: Pediatrics and will be published in the August issue of the journal.

Sixty-one children requiring shunt surgery were assigned randomly to undergo their surgery with antimicrobial sutures, considered the study group, or with usual sutures, which served as the control group. A total of 84 shunt procedures were performed over 21 months. All procedures were performed by one of two pediatric neurosurgeons at Women & Children's Hospital of Kaleida Health in Buffalo.

At the trial's end, the shunt infection rate in the study group was 4.3 percent (2 of 46 procedures), compared to 21 percent (8 of 38 procedures) in the control group.

"Many techniques and devices have been investigated to reduce shunt infection rates," said Curtis J. Rozzelle, M.D., assistant professor of neurosurgery in UB's School of Medicine and Biomedical Sciences and first author on the paper. He also is surgical director of the Comprehensive Epilepsy Program at Women & Children's Hospital. "Some studies, but not all, found that antibiotic-impregnated shunt systems in particular appear to reduce infection risk," noted Rozzelle. "Unfortunately, none of these studies were prospective, randomized and double-blinded.

"In animal trials sutures coated with the antimicrobial triclosan have been shown to reduce the number of bacteria adhering to sutures, but only one study has been published to date on their effect in preventing surgical site infection, so we decided to conduct our own trial," he said.

"Our results showed that using antimicrobial sutures reduced infection risk by 16 percent."

Antibiotic-impregnated shunts, which are used in some surgeries, have several limitations, said Rozzelle: "They don't provide complete protection, they can't be used in patients who are allergic to the antibiotics and they are a lot more expensive than non-impregnated shunts."

"Closing wounds with antimicrobial sutures may reduce infections in procedures implanting other devices, such as pacemakers and neurostimulators, pumps that deliver pharmaceuticals and shunts elsewhere in the body," he said.

Rozzelle and colleagues are planning to conduct a larger randomized controlled trial to confirm their initial findings.

Source: University at Buffalo

Explore further: Flu season, early again, hitting hard in South and Midwest

add to favorites email to friend print save as pdf

Related Stories

People finding their 'waze' to once-hidden streets

19 hours ago

When the people whose houses hug the narrow warren of streets paralleling the busiest urban freeway in America began to see bumper-to-bumper traffic crawling by their homes a year or so ago, they were baffled.

Identity theft victims face months of hassle

19 hours ago

As soon as Mark Kim found out his personal information was compromised in a data breach at Target last year, the 36-year-old tech worker signed up for the retailer's free credit monitoring offer so he would ...

Observers slam 'lackluster' Lima climate deal

19 hours ago

A carbon-curbing deal struck in Lima on Sunday was a watered-down compromise where national intransigence threatened the goal of a pact to save Earth's climate system, green groups said.

Your info has been hacked. Now what do you do?

19 hours ago

Criminals stole personal information from tens of millions of Americans in data breaches this past year. Of those affected, one in three may become victims of identity theft, according to research firm Javelin. ...

New Bond script stolen in Sony hack

19 hours ago

An "early version" of the screenplay for the new James Bond film was the latest victim of a massive hacking attack on Sony Pictures Entertainment, its producers said in a statement on their website Sunday.

Recommended for you

Evidence-based recs issued for systemic care in psoriasis

15 hours ago

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

15 hours ago

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

15 hours ago

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

Discovery of genes that predispose a severe form of COPD

18 hours ago

A study by Ramcés Falfán-Valencia, researcher at the National Institute of Respiratory Diseases (INER), found that the mestizo Mexican population has a number of variations in certain genes that predispose ...

On the environmental trail of food pathogens

19 hours ago

Tracking one of the deadliest food contamination organisms through produce farms and natural environments alike, Cornell microbiologists are showing how to use big datasets to predict where the next outbreak could start.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.