The factors involved in deep brain stimulation infection: a large case series

Stereotact Funct Neurosurg. 2014;92(4):227-33. doi: 10.1159/000362934. Epub 2014 Aug 5.

Abstract

Background: Deep brain stimulation (DBS) is a proven treatment for various movement disorders resistant to medical management. Complications such as postsurgical infection can negate benefits and increase patient morbidity. We sought to better define risk factors for infection.

Methods: We performed a review of DBS cases at our institution from January 1996 to June 2011. Information on multiple metrics including surgical complications, procedural complications and infection were entered into a secure online database.

Results: A total of 447 patients received DBS surgery. Twenty-six (5.82%) developed infection sometime after DBS surgery with 9 (2.01%) developing infection within 30 days after the final staged surgery. Operating surgeon (p = 0.012), scalp erosion (p = 0.0001), surgical incision opening time (0.0001) and number of individuals in the operating room (0.0027) were significant in the cumulative infection group.

Conclusion: The 30-day infection rate was comparably low to other published studies. Several factors were noted to be significant in the cumulative infection group, but none in the 30-day infection group. Further understanding of infection risk factors is important to optimize patient selection and standardize infection-preventative techniques.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Infective Agents, Local
  • Antibiotic Prophylaxis
  • Chlorhexidine / analogs & derivatives
  • Comorbidity
  • Deep Brain Stimulation / adverse effects*
  • Electrodes, Implanted / adverse effects
  • Female
  • Humans
  • Incidence
  • Infection Control / methods
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Period
  • Povidone-Iodine
  • Retrospective Studies
  • Risk Factors
  • Skin Diseases / epidemiology
  • Skin Diseases / etiology
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control
  • Wound Closure Techniques / adverse effects

Substances

  • Anti-Infective Agents, Local
  • Povidone-Iodine
  • chlorhexidine gluconate
  • Chlorhexidine