6Book reviews patient, the presence of concomitant medical disease, season of the year, duration of hospitalization, seniority of the surgeon, and the type of suture material were not found to be significant factors.The author is less certain about the use of antibacterial agents, especially topical bacitricin, in preventing infection.Most of the infections occurred in patients undergoing lumbar disc protrusion surgery.Surprisingly the author recommends excision and packing, and healing by secondary intention as the optimum method of treatment in these cases.No details are given regarding the ventilation of their operating theatres, but reference is made to the use in other hospitals of 'laminar' ventilation (better named 'unidirectional flow ventilation'), which has superseded ordinary plenum systems.There is no mention of the order of the infected operation case in the operating list, or the day of the week, or the apparent source of the infection.Nor are we told if the infections appeared sporadically or as an 'epidemic'.There is scanty reference to bacteriological aspects and this is a notable fault of this otherwise valuable study, which includes a useful survey of the literature on the subject of post-operative wound infections in general, and in neurosurgery in particular.
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I. T. Draper (1971) studied this question.