Surgical site infections in neurosurgical patients following cranial surgery: An integrative review

Aim To synthesise the literature pertaining to surgical site infections (SSIs) in neurosurgical patients following cranial surgery. Background SSIs in neurosurgical patients following cranial surgery present a major healthcare problem for healthcare providers worldwide. The most widely reported outcomes following SSIs include increased length of inpatient stay, morbidity, mortality, higher treatment costs and increased care burden for families and caregivers. Design Integrative review. Methods Using an integrative review framework, electronic database searches were conducted in CINAHL, Embase, Medline and ProQuest from 2012 – 2022. The search was limited to peer reviewed full text publications. Reference lists of identified studies were reviewed, and additional articles were accessed. Methodological rigour for included studies was evaluated using Critical Appraisal Skills Program tools. Results Twenty articles were reviewed, and four themes emerged relating to: preoperative patient preparatory practices and SSIs; risk factors for developing SSIs post cranial surgery; patient-reported outcomes and healthcare implications; and strategies for preventing SSIs within hospital settings. Conclusion Surgical site infections post cranial surgery among neurosurgical patients can be contained through administration of pre-surgical prophylactic antibiotics, adhering to aseptic hand hygiene, utilising evidence based infection control protocols, educating neurosurgical nurse clinicians in post cranial surgical wound care, and providing tailored education for patients and families in postoperative cranial surgical wound care.