Infection following operations on the central nervous system: Deconstructing the myth of the sterile field

Neurosurgical Focus

Volumn 33, Issue 5, 2012, Pages

  Walcott, Brian P ^a   Redjal, Navid ^a   Coumans, Jean Valery C E ^a  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

Author keywords

Antibiotic; Bandage; Complication; Dressing; Glove; Hyperglycemia; Infection; Irrigation; Microbiome; Normothermia; Nutrition; Obesity; Oxygen; Sterile

Indexed keywords

ANTIINFECTIVE AGENT;

ANTIBIOTIC PROPHYLAXIS; BANDAGE; CENTRAL NERVOUS SYSTEM; HUMAN; INFECTION; INSTRUMENT STERILIZATION; METHODOLOGY; NEUROSURGERY; POSTOPERATIVE COMPLICATION; PREOPERATIVE CARE; REVIEW; STANDARD; SURGICAL GLOVE;

ANTI-BACTERIAL AGENTS; ANTIBIOTIC PROPHYLAXIS; BANDAGES; CENTRAL NERVOUS SYSTEM; GLOVES, SURGICAL; HUMANS; INFECTION; NEUROSURGICAL PROCEDURES; POSTOPERATIVE COMPLICATIONS; PREOPERATIVE CARE; STERILIZATION;

EID: 84871441456     PISSN: None     EISSN: 10920684     Source Type: Journal    
DOI: 10.3171/2012.8.FOCUS12245     Document Type: Article

References (109)

1. Alexander JW, Fischer JE, Boyajian M, Palmquist J, Morris MJ: The influence of hair-removal methods on wound infections. Arch Surg 118:347-352, 1983
2. Allen DB, Maguire JJ, Mahdavian M, Wicke C, Marcocci L, Scheuenstuhl H, et al: Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 132:991-996,1997
3. Alvarado R, Alami RS, Hsu G, Safadi BY, Sanchez BR, Morton JM, et al: The impact of preoperative weight loss in patients undergoing laparoscopic Roux-en-Y gastric bypass. Obes Surg 15:1282-1286, 2005
4. Andersson DI, Hughes D: Antibiotic resistance and its cost: is it possible to reverse resistance? Nat Rev Microbiol 8:260-271, 2010
5. Anglen JO: Wound irrigation in musculoskeletal injury. J Am Acad Orthop Surg 9:219-226, 2001
6. Babior BM: Oxygen-dependent microbial killing by phagocytes (first of two parts). N Engl J Med 298:659-668, 1978
7. Barbul A, Lazarou SA, Efron DT, Wasserkrug HL, Efron G: Arginine enhances wound healing and lymphocyte immune responses in humans. Surgery 108:331-337, 1990
8. Beck C: A Manual of the Modern Theory and Technique of Surgical Asepsis. Philadelphia: WB Saunders,1895
9. Belda FJ, Aguilera L, García de la Asunción J, Alberti J, Vicente R, Ferrándiz L, et al: Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA 294:2035-2042, 2005
10. Bhende S, Rothenburger S, Spangler DJ, Dito M: In vitro assessment of microbial barrier properties of Dermabond topical skin adhesive. Surg Infect (Larchmt) 3:251-257, 2002
11. Bible JE, Biswas D, Whang PG, Simpson AK, Grauer JN: Which regions of the operating gown should be considered most sterile? Clin Orthop Relat Res 467:825-830, 2009
12. Bible JE,O'Neill KR, Crosby CG, Schoenecker JG, McGirt MJ, Devin CJ: Microscope sterility during spine surgery.Spine (Phila Pa 1976) 37:623-627, 2012
13. Biswas D, Bible JE, Whang PG, Simpson AK, Grauer JN: Sterility of C-arm fluoroscopy during spinal surgery. Spine (Phila Pa 1976) 33:1913-1917, 2008
14. Blomstedt GC,Kyttä J: Results of a randomized trial of vancomycin prophylaxis in craniotomy. J Neurosurg 69:216-220, 1988
15. Bratzler DW, Houck PM: Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 38:1706-1715, 2004
16. Bratzler DW, Houck PM, Richards C, Steele L, Dellinger EP, Fry DE, et al: Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch Surg 140:174-182, 2005
17. Byrd JJ, Xu HS, Colwell RR: Viable but nonculturable bacteria in drinking water. Appl Environ Microbiol 57:875-878, 1991
18. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP: The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 326:281-286, 1992
19. Cronquist AB, Jakob K, Lai L, Della Latta P, Larson EL: Relationship between skin microbial counts and surgical site infection after neurosurgery. Clin Infect Dis 33:1302-1308, 2001
20. Daly JM, Reynolds J, Thom A, Kinsley L, Dietrick-Gallagher M, Shou J, et al: Immune and metabolic effects of arginine in the surgical patient. Ann Surg 208:512-523, 1988
21. Darouiche RO, Wall MJ Jr, Itani KMF, Otterson MF, Webb AL, Carrick MM, et al: Chlorhexidine-alcohol versus povidone-iodine for surgical-site antisepsis. N Engl J Med 362:18-26, 2010
22. Edwards PS, Lipp A, Holmes A: Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database Syst Rev (3):CD003949, 2004
23. Epstein NE: Do silver-impregnated dressings limit infections after lumbar laminectomy with instrumented fusion? Surg Neurol 68:483-485, 2007
24. Evans HL, Dellit TH, Chan J, Nathens AB, Maier RV, Cuschieri J: Effect of chlorhexidine whole-body bathing on hospital-acquired infections among trauma patients. Arch Surg 145:240-246, 2010
25. Evans RP: Current concepts for clean air and total joint arthroplasty: laminar airflow and ultraviolet radiation: a systematic review. Clin Orthop Relat Res 469:945-953, 2011
26. Furnary AP, Zerr KJ, Grunkemeier GL, Starr A: Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg 67:352-362, 1999
27. Gabig TG, Bearman SI, Babior BM: Effects of oxygen tension and pH on the respiratory burst of human neutrophils. Blood 53:1133-1139, 1979
28. Gallacher SJ, Thomson G, Fraser WD, Fisher BM, Gemmell CG, MacCuish AC: Neutrophil bactericidal function in diabetes mellitus: evidence for association with blood glucose control. Diabet Med 12:916-920, 1995
29. Graffagnino C, Gurram AR, Kolls B, Olson DM: Intensive insulin therapy in the neurocritical care setting is associated with poor clinical outcomes. Neurocrit Care 13:307-312, 2010
30. Grap MJ, Munro CL, Elswick RK Jr, Sessler CN, Ward KR: Duration of action of a single, early oral application of chlorhexidine on oral microbial flora in mechanically ventilated patients: a pilot study. Heart Lung 33:83-91, 2004
31. Greene KA, Wilde AH, Stulberg BN: Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. J Arthroplasty 6:321-325, 1991
32. Greif R, Akça O, Horn EP, Kurz A, Sessler DI: Supplemental perioperative oxygen to reduce the incidence of surgicalwound infection. N Engl J Med 342:161-167, 2000
33. Gruskay J, Kepler C, Smith J, Radcliff K, Vaccaro A: Is surgical case order associated with increased infection rate after spine surgery? Spine (Phila Pa 1976) 37:1170-1174, 2012
34. Guest JD, Vanni S, Silbert L: Mild hypothermia, blood loss and complications in elective spinal surgery. Spine J 4:130-137, 2004
35. Guo YP, Wong PM, Li Y, Or PPL: Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery. Am J Surg 204:210-215, 2012
36. Hall LT, Bailes JE: Using Dermabond for wound closure in lumbar and cervical neurosurgical procedures. Neurosurgery 56 (1 Suppl):147-150, 2005
37. Harbarth S, Samore MH, Lichtenberg D, Carmeli Y: Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation 101:2916-2921, 2000
38. Hardy SJ, Nowacki AS, Bertin M, Weil RJ: Absence of an association between glucose levels and surgical site infections in patients undergoing craniotomies for brain tumors. Clinical article. J Neurosurg 113:161-166, 2010
39. Harjula A, Järvinen A: Postoperative median sternotomy dehiscence. Scand J Thorac Cardiovasc Surg 17:277-281, 1983
40. Hassinger SM, Harding G, Wongworawat MD: High-pressure pulsatile lavage propagates bacteria into soft tissue. Clin Orthop Relat Res 439:27-31, 2005
41. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AHS, Dellinger EP, et al: A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491-499, 2009
42. Herman LG: Sources of the slow-growing pigmented water bacteria. Health Lab Sci 13:5-10, 1976
43. Hughes MA, Parisi M, Grossman S, Kleinberg L: Primary brain tumors treated with steroids and radiotherapy: low CD4 counts and risk of infection. Int J Radiat Oncol Biol Phys 62: 1423-1426, 2005
44. Jenkins S, Addy M, Wade W: The mechanism of action of chlorhexidine. A study of plaque growth on enamel inserts in vivo. J Clin Periodontol 15:415-424, 1988
45. Kirby WM, Regamey C: Pharmacokinetics of cefazolin compared with four other cephalosporins. J Infect Dis 128:S341- S346, 1973
46. Kirk SJ, Hurson M, Regan MC, Holt DR, Wasserkrug HL, Barbul A: Arginine stimulates wound healing and immune function in elderly human beings. Surgery 114:155-160, 1993
47. Klein JD, Garfin SR: Nutritional status in the patient with spinal infection. Orthop Clin North Am 27:33-36, 1996
48. Kumar K, Crawford AH: Role of "Bovie" in spinal surgery: historical and analytical perspective. Spine (Phila Pa 1976) 27:1000-1006, 2002
49. Kurz A, Sessler DI, Lenhardt R: Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med 334:1209-1215, 1996
50. Leslie-Mazwi TM, Sims JR, Hirsch JA, Nogueira RG: Periprocedural blood pressure management in neurointerventional surgery. J Neurointerv Surg 3:66-73, 2011
51. Levitt MR, Gabikian P, Pottinger PS, Silbergeld DL: Propionibacterium acnes osteomyelitis occurring 23 years after craniotomy: case report and review of literature. Neurosurgery 69:E773-E779, 2011
52. Lidwell OM, Elson RA, Lowbury EJL, Whyte W, Blowers R, Stanley SJ, et al: Ultraclean air and antibiotics for prevention of postoperative infection. A multicenter study of 8,052 joint replacement operations. Acta Orthop Scand 58:4-13, 1987
53. Lidwell OM, Lowbury EJ, Whyte W, Blowers R, Stanley SJ, Lowe D: Effect of ultraclean air in operating rooms on deep sepsis in the joint after total hip or knee replacement: a randomised study. Br Med J (Clin Res Ed) 285:10-14, 1982
54. Lopez M, Sessler DI, Walter K, Emerick T, Ozaki M: Rate and gender dependence of the sweating, vasoconstriction, and shivering thresholds in humans. Anesthesiology 80:780-788, 1994
55. Losanoff JE, Richman BW, Jones JW: Disruption and infection of median sternotomy: a comprehensive review. Eur J Cardiothorac Surg 21:831-839, 2002
56. Mack D, Fischer W, Krokotsch A, Leopold K, Hartmann R, Egge H, et al: The intercellular adhesin involved in biofilm accumulation of Staphylococcus epidermidis is a linear beta- 1,6-linked glucosaminoglycan: purification and structural analysis. J Bacteriol 178:175-183, 1996
57. Magyar CE, Aghaloo TL, Atti E, Tetradis S: Ostene, a new alkylene oxide copolymer bone hemostatic material, does not inhibit bone healing. Neurosurgery 63 (4 Suppl 2):373-378, 2008
58. Manz W, Szewzyk U, Ericsson P, Amann R, Schleifer KH, StenstrWebster J, Alghamdi AA: Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database Syst Rev (4):CD006353, 2007öm TA: In situ identification of bacteria in drinking water and adjoining biofilms by hybridization with 16S and 23S rRNA-directed fluorescent oligonucleotide probes. Appl Environ Microbiol 59:2293-2298, 1993
59. Matzke GR, Zhanel GG, Guay DR: Clinical pharmacokinetics of vancomycin. Clin Pharmacokinet 11:257-282, 1986
60. McPhee IB, Williams RP, Swanson CE: Factors influencing wound healing after surgery for metastatic disease of the spine. Spine 23:726-733, 1998
61. Mehta AI, Babu R, Karikari IO, Grunch B, Agarwal VJ, Owens TR, et al: 2012 Young Investigator Award Winner: The distribution of body mass as a significant risk factor for lumbar spinal fusion postoperative infections. Spine (Phila Pa 1976) 37:1652-1656, 2012
62. Mekalanos JJ: Environmental signals controlling expression of virulence determinants in bacteria. J Bacteriol 174:1-7, 1992
63. Miller JP, Acar F, Burchiel KJ: Significant reduction in stereotactic and functional neurosurgical hardware infection after local neomycin/polymyxin application. Clinical article. J Neurosurg 110:247-250, 2009
64. Miller MB,Bassler BL: Quorum sensing in bacteria. Annu Rev Microbiol 55:165-199, 2001
65. Montagna W: The Structure and Function of Skin, ed 2. New York: Academic Press, 1962
66. Nakamura K, Kariyazono H, Komokata T, Hamada N, Sakata R, Yamada K: Influence of preoperative administration of w-3 fatty acid-enriched supplement on inflammatory and immune responses in patients undergoing major surgery for cancer. Nutrition 21:639-649, 2005
67. Nishida H, Grooters RK, Soltanzadeh H, Thieman KC, Schneider RF, Kim WP: Discriminate use of electrocautery on the median sternotomy incision. A 0.16% wound infection rate. Discussion J Thorac Cardiovasc Surg 101:488-494, 1991
68. Nornes H, Knutzen HB, Wikeby P: Cerebral arterial blood flow and aneurysm surgery. Part 2: Induced hypotension and autoregulatory capacity. J Neurosurg 47:819-827, 1977
69. Parienti JJ, Thibon P, Heller R, Le Roux Y, von Theobald P, Bensadoun H, et al: Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. JAMA 288:722-727, 2002 (Erratum in JAMA 288:2689, 2002)
70. Perley M, Kipnis DM: Effect of glucocorticoids on plasma insulin. N Engl J Med 274:1237-1241, 1966
71. Perner A, Nielsen SE, Rask-Madsen J: High glucose impairs superoxide production from isolated blood neutrophils. Intensive Care Med 29:642-645, 2003
72. Pople IK, Bayston R, Hayward RD: Infection of cerebrospinal fluid shunts in infants: a study of etiological factors. J Neurosurg 77:29-36, 1992
73. Porter KA, O'Connor S, Rimm E, Lopez M: Electrocautery as a factor in seroma formation following mastectomy. Am J Surg 176:8-11, 1998
74. Proctor LM: The human microbiome project in 2011 and beyond. Cell Host Microbe 10:287-291, 2011
75. Pryor KO, Fahey TJ III, Lien CA, Goldstein PA: Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA 291:79-87, 2004
76. Puig-Kröger A, Pello OM, Selgas R, Criado G, Bajo MA, Sánchez- Tomero JA, et al: Peritoneal dialysis solutions inhibit the differentiation and maturation of human monocyte-derived dendritic cells: effect of lactate and glucose-degradation products. J Leukoc Biol 73:482-492, 2003 (Erratum in J Leukoc Biol 82:1605, 2007)
77. Reasoner DJ, Geldreich EE: A new medium for the enumeration and subculture of bacteria from potable water. Appl Environ Microbiol 49:1-7, 1985
78. Rhoton AL Jr: Operative techniques and instrumentation for neurosurgery. Neurosurgery 53:907-934, 2003
79. Roberts RR, Hota B, Ahmad I, Scott RD II, Foster SD, Abbasi F, et al: Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clin Infect Dis 49:1175-1184, 2009
80. Sarlis NJ, Chanock SJ, Nieman LK: Cortisolemic indices predict severe infections in Cushing syndrome due to ectopic production of adrenocorticotropin. J Clin Endocrinol Metab 85:42-47, 2000
81. Segers P, Speekenbrink RGH, Ubbink DT, van Ogtrop ML, de Mol BA: Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial. JAMA 296:2460-2466, 2006
82. Sessler DI, Rubinstein EH, Moayeri A: Physiologic responses to mild perianesthetic hypothermia in humans. Anesthesiology 75:594-610, 1991
83. Shiono Y, Watanabe K, Hosogane N, Tsuji T, Ishii K, Nakamura M, et al: Sterility of posterior elements of the spine in posterior correction surgery. Spine (Phila Pa 1976) 37:523- 526, 2012
84. Singer AJ, Clark RA: Cutaneous wound healing. N Engl J Med 341:738-746, 1999
85. Smith GC, Pell JP: Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ 327:1459-1461, 2003
86. Snyderman CH, Kachman K, Molseed L, Wagner R, D'Amico F, Bumpous J, et al: Reduced postoperative infections with an immune-enhancing nutritional supplement. Laryngoscope 109:915-921, 1999
87. Soballe PW, Nimbkar NV, Hayward I, Nielsen TB, Drucker WR: Electric cautery lowers the contamination threshold for infection of laparotomies. Am J Surg 175:263-266, 1998
88. St Jacques P, Sanders N, Patel N, Talbot TR, Deshpande JK, Higgins M: Improving timely surgical antibiotic prophylaxis redosing administration using computerized record prompts. Surg Infect (Larchmt) 6:215-221, 2005
89. Still CD, Benotti P, Wood GC, Gerhard GS, Petrick A, Reed M, et al: Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg 142: 994-999, 2007
90. Stocks GW, Self SD, Thompson B, Adame XA, O'Connor DP: Predicting bacterial populations based on airborne particulates: a study performed in nonlaminar flow operating rooms during joint arthroplasty surgery. Am J Infect Control 38:199-204, 2010
91. Stranc MF, McDiarmid JG, Stranc LC: Video assessment of surgical technique. Br J Plast Surg 44:65-68, 1991
92. Tanner J, Parkinson H: Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev (3):CD003087, 2006
93. Tanner J, Swarbrook S, Stuart J: Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev (1):CD004288, 2008
94. Tanner J, Woodings D, Moncaster K: Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev (3):CD004122, 2006
95. Tepaske R, Velthuis H, Oudemans-van Straaten HM, Heisterkamp SH, van Deventer SJH, Ince C, et al: Effect of preoperative oral immune-enhancing nutritional supplement on patients at high risk of infection after cardiac surgery: a randomised placebo-controlled trial. Lancet 358:696-701, 2001
96. Todd MM, Hindman BJ, Clarke WR, Torner JC: Mild intraoperative hypothermia during surgery for intracranial aneurysm. N Engl J Med 352:135-145, 2005
97. Toma O, Suntrup P, Stefanescu A, London A, Mutch M, Kharasch E: Pharmacokinetics and tissue penetration of cefoxitin in obesity: implications for risk of surgical site infection. Anesth Analg 113:730-737, 2011
98. Walsh TJ, Mendelsohn G: Invasive aspergillosis complicating Cushing's syndrome. Arch Intern Med 141:1227-1228, 1981
99. Weaver DD, inventor; MegaDyne Medical Products, Inc, assignee: Coated bipolar electrocautery. US patent 5,693,052. December 2, 1997
100. Webster J, Alghamdi AA: Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database Syst Rev (4):CD006353, 2007
101. Webster J, Osborne S: Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev (2):CD004985, 2006
102. Weiner BK, Kilgore WB: Bacterial shedding in common spine surgical procedures: headlamp/loupes and the operative microscope. Spine (Phila Pa 1976) 32:918-920, 2007
103. Wellisz T, Armstrong JK, Cambridge J, Fisher TC: Ostene, a new water-soluble bone hemostasis agent. J Craniofac Surg 17:420-425, 2006
104. Winston KR: Hair and neurosurgery. Neurosurgery 31:320- 329, 1992
105. Winston KR, McBride LA, Dudekula A: Bandages, dressings, and cranial neurosurgery. J Neurosurg 106 (6 Suppl):450- 454, 2007
106. Wolcott RD, Gontcharova V, Sun Y, Zischakau A, Dowd SE: Bacterial diversity in surgical site infections: not just aerobic cocci any more. J Wound Care 18:317-323, 2009
107. Zanetti G, Flanagan HL Jr, Cohn LH, Giardina R, Platt R: Improvement of intraoperative antibiotic prophylaxis in prolonged cardiac surgery by automated alerts in the operating room. Infect Control Hosp Epidemiol 24:13-16, 2003
108. Zanetti G, Giardina R, Platt R: Intraoperative redosing of cefazolin and risk for surgical site infection in cardiac surgery. Emerg Infect Dis 7:828-831, 2001
109. Zeh A, Messer J, Davis J, Vasarhelyi A, Wohlrab D: The Aquamantys system-an alternative to reduce blood loss in primary total hip arthroplasty? J Arthroplasty 25:1072- 1077, 2010