J.Jpn. Surg. Soc.. 83(2): 186-191, 1982

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Original article

POSTOPERATIVE INFECTIONS IN NEUROLOGICAL SURGERY

Postoperative infection would be counted one of serious complications in the field of neurosurgical practice. They are classified into two types of infection, i.e. systemic infection and infection to the central nervous system (CNS) itself. This study is to clarify the incidence of postoperative infection with the above-mentioned two categories in our series of surgery.
From the all 1,200 operative cases for the last 6 years, a series of 1,002 clean cases were investigated with clinical records in this study. In almost all cases prophylactic antibiotics were administered preoperatively. Criteria of the infection was devided into two subgraups ; namely, one was the apparent infected case with positive etiological organism and the other was the possible infected case who had only clinical sign of infection without evidence of organism proven. The former was counted 69 cases (6.9%) and the latter 116 cases (11.6%) and no infection was noted in 817 (81.5%) in our series.
Systemic infection was counted 18.5% with positive 6.9% and possible 11.6% in its incidence. The commonest infection were cystitis, pneumonia, meningitis and thrombophlebitis. There were no seasonal variations noted in their occurrence. Cystitis was 1.8 times commoner in female than male patients. A correlation between increasing age of the patient and increased likelihood of systemic infection was noted except for the patients below the age of second decades. There were also pointed to be a clear relationship between length of operation and the likelihood of postoperative infection. Organisms found by culture varied in kind and many opportunists were included such as Klebsiella, Pseudomonas aeruginosa and Serratia.
Positive : and possible infections to CNS were noted to be 3.6% altogether. Meningitis (29 cases), wound infection (4 cases), brain abscess (2 cases) and ventriculitis (1 cases) were encountered. It was our impression in this investigation that important predisposing factors to the infection of CNS were reopening of the wound, patient with tracheostomy, diabetes mellitus, ventricular drainages or shunting procedure and emergency operations.

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