Development of Protocol for Ventriculoperitoneal Shunt Surgery in Paediatric Patients to Reduce Shunt Infection

Abstract

Background: Ventriculoperitoneal shunt (VPS) is the most common treatment modality for hydrocephalus. However, VPS infection is acommon and serious complication with high rates of mortality and morbidity and there is some emerging evidence suggesting that adherence to a strict protocol may be important in reducing the rate of shunt infection. Objectives: To develop a protocol for initial ventriculoperitoneal shunt surgery and assess the efficacy of this protocol in reducing ventriculoperitoneal shunt infection rate. Materials and Methods: This study was a comparative study was carried out in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from December 2021 to March 2023. Total 100 patients were included in this study. Patients < 18 years of age undergoing initial ventriculoperitoneal shunt surgery for hydrocephalus due to various etiologies in the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University. Data collection sheet was used to collect the necessary information. Voluntary written informed consent was taken from the patients and/or the legal guardian/responsible family members after completely explaining to them the procedure and the purpose of the study. Using simple random sampling by lottery method, the patients were divided into a study group and a control group. Patients in the study group underwent ventriculoperitoneal shunt surgery as per the proposed surgery protocol and strict adherence to the protocol by the operating surgeon was ensured. Patients in the control group underwent ventriculoperitoneal shunt surgery as per the current standard practice. Post-operative care of the patient was carried out as per the standard practice in both the groups. Follow-up of the patients were done on an outpatient department basis at 1 month and at 3 months postoperatively, where they were examined thoroughly for signs and symptoms of shunt infection. Patients not showing up at the outpatient department were ...