Scrubbing technique and surgical site infections: An analysis of 14,200 neurosurgical cases

Ahmed Kashkoush, Nitin Agarwal, Ashley Ayres, Victoria Novak, Yue Fang Chang, Robert M. Friedlander

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

OBJECTIVE The preoperative scrub has been shown to lower the incidence of surgical site infections (SSIs). Various scrubbing and gloving techniques exist; however, it is unknown how specific scrubbing technique influences SSI rates in neurosurgery. The authors aimed to assess whether the range of scrubbing practice in neurosurgery is associated with the incidence of SSIs. METHODS The authors conducted a retrospective review of a prospectively maintained database to identify all 90-day SSIs for neurosurgical procedures between 2012 and 2017 at one of their teaching hospitals. SSIs were classified by procedure type (craniotomy, shunt, fusion, or laminectomy). Surveys were administered to attending and resident physicians to understand the variation in scrubbing methods (wet vs dry, iodine vs chlorhexidine, single vs double glove). The chi-square followed by multivariate logistic regression analyses were utilized to identify independent predictors of SSI. RESULTS Forty-two operating physicians were included in the study (18 attending physicians, 24 resident physicians), who performed 14,200 total cases. Overall, SSI rates were 2.1% (296 SSIs of 14,200 total cases) and 2.0% (192 of 9,669 cases) for attending physicians and residents, respectively. Shunts were independently associated with an increased risk of SSI (OR 1.7 [95% CI 1.3–2.1]), whereas laminectomies were associated with a decreased SSI risk (OR 0.4 [95% CI 0.2–0.8]). Wet versus dry scrub (OR 0.9 [95% CI 0.6–1.4]), iodine versus chlorhexidine (OR 0.6 [95% CI 0.4–1.1]), and single- versus double-gloving (OR 1.1 [95% CI 0.8–1.4]) preferences were not associated with SSIs. CONCLUSIONS There is no evidence to suggest that perioperative infection is associated with personal scrubbing or gloving preference in neurosurgical procedures.

Original languageEnglish
Pages (from-to)580-587
Number of pages8
JournalJournal of neurosurgery
Volume133
Issue number2
DOIs
StatePublished - Aug 2020

Keywords

  • Hand hygiene
  • Neurosurgery
  • Scrubbing technique
  • Surgical site infection

Fingerprint

Dive into the research topics of 'Scrubbing technique and surgical site infections: An analysis of 14,200 neurosurgical cases'. Together they form a unique fingerprint.

Cite this