Background: Surgical drains are widely used despite limited evidence in their favor. This study describes the associations between drains and surgical site infections (SSI).
Methods: This prospective observational double center study was performed in Switzerland between February 2013 and August 2015.
Results: The odds of SSI in the presence of drains were increased in general (OR 2.41, 95%CI 1.32-4.30, p = 0.004), but less in vascular and not in orthopedic trauma surgery. In addition to the surgical division, the association between drains and SSI depended significantly on the duration of surgery (p = 0.01) and wound class (p = 0.034). Furthermore, the duration of drainage (OR 1.24, 95%CI 1.15-1.35, p < 0.001), the number (OR 1.74, 95%CI 1.09-2.74, p = 0.019) and type of drains (open versus closed: OR 3.68, 95%CI 1.88, 6.89, p < 0.001) as well as their location (overall p = 0.002) were significantly associated with SSI.
Conclusions: The general use of drains is discouraged. However, drains may be beneficial in specific surgical procedures.
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http://dx.doi.org/10.1016/j.amjsurg.2018.06.015 | DOI Listing |
J Med Syst
January 2025
Department of Neurosurgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
This study aimed to develop and validate a cost-effective, customizable patient-specific phantom for simulating external ventricular drain placement, combining image segmentation, 3-D printing and molding techniques. Two variations of the phantom were created based on patient MRI data, integrating a realistic skin layer with anatomical landmarks, a 3-D printed skull, an agarose polysaccharide gel brain, and a ventricular cavity. To validate the phantom, 15 neurosurgeons, residents, and physician assistants performed 30 EVD placements.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of surgery, Medical college, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia.
Spinal cord ischemia and injury pose significant challenges in spinal surgery and traumatic events. Cerebrospinal drains are considered a potential intervention to mitigate these risks, although their efficacy and safety are uncertain. We conducted a comprehensive systematic review and meta-analysis to evaluate the efficacy and safety of cerebrospinal drains in preventing and managing spinal cord ischemia and injury.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
January 2025
Neurological Surgery.
Background: We implemented a quality improvement project to transition from routine cerebrospinal fluid (CSF) sampling to indication-based sampling in aneurysmal subarachnoid hemorrhage (aSAH) patients with an external ventricular drain (EVD).
Methods: Forty-seven patients were assessed across 2 epochs: routine (n=22) and indication-based (n=25) CSF sampling. The primary outcome was the number of CSF samples, and secondary outcomes included cost reductions and ventriculostomy-associated infections.
Insights Imaging
January 2025
Department of Radiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, PR China.
Objective: To determine the value of preoperative CT perfusion (CTP) parameters for prediction of post-revascularization cerebral infarction (post-CI) in adults with moyamoya disease (MMD).
Methods: This retrospective study included 92 adults with MMD who underwent surgical revascularization. Preoperative quantitative CTP parameters, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to drain (TTD), and transit time to maximum of the residue function (Tmax), along with clinical data, were compared between the groups with and without post-CI.
Sci Rep
January 2025
Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
We investigated the safety and performance of the Da Vinci SP single-port robot (SP robot) in nipple-sparing mastectomy (NSM) with immediate reconstruction. Medical records of 60 women aged ≥ 19 years who had undergone SP robot-assisted unilateral or bilateral NSM with immediate reconstruction between October 2020 and August 2021 were retrospectively analyzed. Stage I (31, 47.
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