機能神経外科における感染—デバイスを用いた手術を中心に

Infections in Functional Neurosurgery:Focusing on Device-based Surgery

Point

・デバイスを用いる手術が多い機能神経外科において，手術部位感染は最も注意すべき手術合併症である．

・感染予防としては消毒，創部の洗浄，抗菌薬の適切な使用，丁寧な縫合，そして迅速な手技が基本かつ最重要である．

・感染判明後は速やかに対応し，患者のADL，QOL低下を最小限にするためにあらゆる対策を講じる．

　Functional neurosurgery for epilepsy, movement disorders, and spasticity includes some device-based surgeries such as deep brain stimulation, subdural electrode placement, vagus nerve stimulation, and baclofen pump implantation. These surgeries have a higher risk of surgical site infection（SSI）than other general neurological surgeries. Furthermore, because device removal after infection can significantly impair patients'activities of daily living and quality of life, SSI in functional neurosurgery is a worrisome surgical complication. In this study, we conducted a mini-review of the risk of infection in each device-based surgery and described associated surgical procedures and preparations performed at our institution, with a focus on infection prevention.