Wound Infections Complicating Neurosurgical Procedures

ESPITE the mos t diligent a t ten t ion to asepsis during any surgical procedure, pos topera t ive infection remains a threat . The magni tude of this problem on the Neurosurgical Service a t the U C L A Center for the Hea l th Sciences is the subject of this report . This s tudy was undert aken to provide the surgeon with a clear idea of the infection rate so t ha t techniques of asepsis could be be t te r eva lua ted and to provide a basis for discussion of risks of a surgical procedure with pa t ien ts and their families. An a t t e m p t was made to determine the total incidence of infections t ha t developed in clean operat ive wounds. The na ture of the various factors which m a y lead to infection were examined, and the incidence of infection was related to specific neurosurgical procedures. There are ample reports concerning the general surgical experience with this problem; however, neurosurgical repor ts are less abundant . Woodhall , et al., 12 repor ted their experience with 4~ infections in 3,019 operations over a 10-year period. In addit ion, they summarized the reported experience of Cairns, 3 Pennybacker , 1~ and Penfield2 These rates varied f rom a low of 0.69% (5,066 operations) to a high of 4.4cflv (1,169 operations). A more recent repor t n described an unusual ly high incidence (10.~%) of infectious complications. In addit ion to these specific reports, infection has been included among complications in published reports of specific neurosurgical operat ions 2,5,6,s or neurosurgical infection by a specific bacterial organism. 1,4