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Effectiveness of subgaleal topical vancomycin powder in reducing infection rates and shunt revisions in pediatric ventriculoperitoneal shunt surgery: a promising prophylactic approach. | LitMetric

AI Article Synopsis

  • - This study investigates the effectiveness of two preventive methods for shunt infections in kids undergoing ventriculoperitoneal shunt surgery, comparing vancomycin solution washing (Group 1) versus vancomycin powder application after surgery (Group 2).
  • - An analysis of 56 pediatric patients revealed that the vancomycin powder group experienced significantly fewer early (3.3% vs. 26.9%) and late (3.3% vs. 30.7%) postoperative infections, and no shunt revisions were needed in this group compared to 26.9% in the solution group.
  • - The study concludes that applying topical vancomycin powder is an effective strategy for reducing infection rates

Article Abstract

Purpose: This study aims to evaluate the effectiveness of two prophylactic strategies in preventing shunt infections in pediatric patients undergoing ventriculoperitoneal shunt surgery.

Methods: This retrospective study included pediatric patients who underwent ventriculoperitoneal shunt surgery between 2017 and 2024. Patients were divided into two groups based on the prophylactic method used: Group 1 (VS) where the shunt was washed with vancomycin solution before placement, and Group 2 (TVP) where vancomycin powder was applied to the subgaleal and subcutaneous tissues after shunt placement. Data collected included age, gender, preoperative CRP values, operation length, hospitalization duration, wound site problems, and rates of early (within 3 days) and late (within 36 months) postoperative infections and shunt revisions.

Results: Data from 56 pediatric patients were analyzed. The TVP group had significantly lower rates of early postoperative infections compared to the VS group (3.3% vs. 26.9%, p < 0.05). Late postoperative infections were also lower in the TVP group (3.3% vs. 30.7%, p < 0.05). Shunt revision was required in 26.9% of patients in the VS group, but none in the TVP group (p < 0.05). Wound site problems were a critical factor, with all patients experiencing wound site infections also developing early postoperative infections (p < 0.05).

Conclusion: The use of subgaleal topical vancomycin powder is a promising prophylactic method in ventriculoperitoneal shunt surgery, particularly for pediatric patients who are prone to skin problems, as it effectively avoids systemic toxic effects while reducing infection rates and the need for shunt revisions.

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Source
http://dx.doi.org/10.1007/s00381-024-06672-6DOI Listing

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