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Article: Extended subcutaneous tunnelling technique for external ventricular drainage

TitleExtended subcutaneous tunnelling technique for external ventricular drainage
Authors
KeywordsCerebrospinal fluid
Risk factor
Ventriculostomy catheter
Ventriculostomy-related infection
Issue Date2007
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/02688697.asp
Citation
British Journal Of Neurosurgery, 2007, v. 21 n. 4, p. 359-364 How to Cite?
AbstractInfection is a serious complication of external ventricular drain (EVD) and various strategies have been adopted to minimize its occurrence. The use of an extended subcutaneous tunnel (50-60 cm) was previously described, but has since received little attention in the literature. The authors reviewed their experience with this technique, with emphasis on the rate of infection and predisposing risk factors. This is a retrospective review of 114 patients who received EVD with extended subcutaneous tunnel ('long EVD'). Fourteen of the 114 patients underwent more than one insertion, and a total of 133 cases of 'long EVD' were included. The mean duration of drainage was 20 days. One-hundred-and-three cases started without pre-existent infection and seven became infected, yielding an overall infection rate of 6.8%. The majority of infections were found within the first 5 days and in the third week of drainage. There was, however, no statistically significant difference in daily infection risks between the first, second and third weeks. Only intraventricular instillation of urokinase was identified as a statistically significant risk factor. Non-infective complications occurred in 17 cases (12.8%). In the present study, the overall infection rate of the 'long EVD' was comparable with that of conventional EVD, as reported by other authorities in the literature. The extended subcutaneous tunnel technique did not affect the daily infection risk on a week-to-week basis. The 'long EVD' does not appear to offer any distinct advantage over the standard tunnelling technique in our unit. However, this is essentially an audit within a single centre, and the findings should be interpreted with caution and with the understanding that individual institutions may have their unique patterns and risks of EVD infection. © The Neurosurgical Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/83990
ISSN
2015 Impact Factor: 1.063
2015 SCImago Journal Rankings: 0.469
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLeung, GKKen_HK
dc.contributor.authorNg, KBen_HK
dc.contributor.authorTaw, BBTen_HK
dc.contributor.authorFan, YWen_HK
dc.date.accessioned2010-09-06T08:47:37Z-
dc.date.available2010-09-06T08:47:37Z-
dc.date.issued2007en_HK
dc.identifier.citationBritish Journal Of Neurosurgery, 2007, v. 21 n. 4, p. 359-364en_HK
dc.identifier.issn0268-8697en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83990-
dc.description.abstractInfection is a serious complication of external ventricular drain (EVD) and various strategies have been adopted to minimize its occurrence. The use of an extended subcutaneous tunnel (50-60 cm) was previously described, but has since received little attention in the literature. The authors reviewed their experience with this technique, with emphasis on the rate of infection and predisposing risk factors. This is a retrospective review of 114 patients who received EVD with extended subcutaneous tunnel ('long EVD'). Fourteen of the 114 patients underwent more than one insertion, and a total of 133 cases of 'long EVD' were included. The mean duration of drainage was 20 days. One-hundred-and-three cases started without pre-existent infection and seven became infected, yielding an overall infection rate of 6.8%. The majority of infections were found within the first 5 days and in the third week of drainage. There was, however, no statistically significant difference in daily infection risks between the first, second and third weeks. Only intraventricular instillation of urokinase was identified as a statistically significant risk factor. Non-infective complications occurred in 17 cases (12.8%). In the present study, the overall infection rate of the 'long EVD' was comparable with that of conventional EVD, as reported by other authorities in the literature. The extended subcutaneous tunnel technique did not affect the daily infection risk on a week-to-week basis. The 'long EVD' does not appear to offer any distinct advantage over the standard tunnelling technique in our unit. However, this is essentially an audit within a single centre, and the findings should be interpreted with caution and with the understanding that individual institutions may have their unique patterns and risks of EVD infection. © The Neurosurgical Foundation.en_HK
dc.languageengen_HK
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/02688697.aspen_HK
dc.relation.ispartofBritish Journal of Neurosurgeryen_HK
dc.rightsBritish Journal of Neurosurgery. Copyright © Informa Healthcare.en_HK
dc.subjectCerebrospinal fluiden_HK
dc.subjectRisk factoren_HK
dc.subjectVentriculostomy catheteren_HK
dc.subjectVentriculostomy-related infectionen_HK
dc.titleExtended subcutaneous tunnelling technique for external ventricular drainageen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0268-8697&volume=21&issue=4&spage=359&epage=364&date=2007&atitle=Extended+subcutaneous+tunnelling+technique+for+external+ventricular+drainageen_HK
dc.identifier.emailLeung, GKK: gilberto@hkucc.hku.hken_HK
dc.identifier.authorityLeung, GKK=rp00522en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/02688690701392881en_HK
dc.identifier.pmid17676455-
dc.identifier.scopuseid_2-s2.0-34547697329en_HK
dc.identifier.hkuros137821en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34547697329&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue4en_HK
dc.identifier.spage359en_HK
dc.identifier.epage364en_HK
dc.identifier.isiWOS:000249247100010-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLeung, GKK=35965118200en_HK
dc.identifier.scopusauthoridNg, KB=18434416600en_HK
dc.identifier.scopusauthoridTaw, BBT=18434973000en_HK
dc.identifier.scopusauthoridFan, YW=7403492523en_HK

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