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Updated: Jun 12, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
A simple method to reduce infection of ventriculoperitoneal shunts
Atiq-Ur Rehman1, Tausif-Ur Rehman, Hassaan H Bashir
1Department of Neurosurgery, King Fahd Specialists Hospital, Al-Qassim, Saudi Arabia.
Object:
Postoperative shunt infection is the most common and feared complication of ventriculoperitoneal (VP) shunt placement for treatment of hydrocephalus. The rate of shunt infection is highest in the 1st postoperative month. The most common organisms responsible for shunt infection include coagulase-negative Staphylococcus and Staphylococcus aureus. This suggests a transfer of patient's skin flora via the surgeons' glove as a possible means of infection. The authors conducted a study to determine if the rate of postoperative shunt infections could be reduced simply by changing gloves before handling the shunt catheter.
Methods:
A total of 111 neonates born with congenital hydrocephalus requiring a VP shunt were enrolled retrospectively and divided into 2 groups: a control group of 54 neonates treated with standard protocol VP shunt placement (Group A) and a treatment group of 57 neonates in whom, after initially double gloving, the outer pair of gloves was removed before handling the shunt catheter (Group B). Shunt infection rates were compared up to 6 months postoperatively.
Results:
There was a statistically significant reduction of infection rate from 16.33% in Group A (control) to 3.77% in Group B (p = 0.0458).
Conclusions:
The study shows that a changing of gloves before handling the shunt catheter may be a simple and cost-effective way to reduce the burden of postoperative shunt infections.
Insights
Changing surgical gloves before handling shunt catheters significantly reduced postoperative infections in neonates with hydrocephalus. This simple, cost-effective method lowers infection rates, improving patient outcomes.
Area of Science:
- Neurosurgery
- Infectious Disease Prevention
Background:
- Postoperative shunt infection is a major complication of ventriculoperitoneal (VP) shunt placement for hydrocephalus.
- Infection rates are highest in the first postoperative month, often caused by skin flora like Staphylococcus.
- Surgeons' gloves are a suspected vector for transferring skin flora to the shunt catheter.
Purpose of the Study:
- To evaluate if changing gloves before shunt catheter handling reduces postoperative infection rates.
- To assess a simple, potentially cost-effective intervention for preventing VP shunt infections.
Main Methods:
- A retrospective study of 111 neonates with congenital hydrocephalus undergoing VP shunt placement.
- Two groups were compared: a control group (Group A) with standard protocol and a treatment group (Group B) where the outer glove was changed before catheter handling.
- Shunt infection rates were monitored for up to 6 months postoperatively.
Main Results:
- The infection rate in the treatment group (Group B) was significantly lower at 3.77% compared to the control group (Group A) at 16.33%.
- The reduction in infection rate was statistically significant (p = 0.0458).
Conclusions:
- Changing gloves before handling the shunt catheter is a simple and effective method to reduce postoperative shunt infections.
- This practice offers a cost-effective strategy to mitigate the risks associated with VP shunt placement.
- Implementing this glove change protocol can decrease the overall burden of shunt infections in neurosurgical patients.
