Use of Closed Drainage System for a Period Between 3 To 7 Days, Under Antibiotic Cover is Safe in Chronic Subdural Hematoma Treatment
Keywords:
Chronic subdural hematoma,, burr hole irrigation,, continuous drainage.Abstract
Chronic subdural hematoma is a common neurosurgical problem in the elderly. There has been interest in the use of closed system drainage after initial irrigation. This may lead to infection. The objective of our study was to assess the risk of infection with the use of drain over a period of 7 days. In 27 patients closed system drainage was used. It was removed whenever drainage became less than 25 ml/24 hours. The upper limit for keeping the drain was 7 days. None of the patients required the drain for more than 7 days. The risk of meningitis was assessed. There was no patient who developed local wound infection or meningitis. Conclusion: It is safe to use closed drainage system for continued drainage of chronic subdural hematoma under antibiotic cover for 7 days.
References
2. Mauro Soto-Granados. Treatment of chronic subdural hematoma through a burr hole. Cir. 2010; 78: 203-7.
3. Koivisto T, Jääskeläinen JE. Chronic subdural haema-toma--to drain or not to drain? Lancet. 2009 Sep 26; 374 (9695): 1040-1.
4. GJ Yu, CZ Han, M Zhang, HT Zhuang, YG Jiang, Pro-longed drainage reduces the recurrence of chronic sub-dural hematoma. Br J Neurosurg. 2009 Dec; 23 (6): 606-11.
5. Han HJ, Park CW, Kim EY, Yoo CJ, Kim YB, Kim WK. One vs. Two Burr Hole Craniostomy in Surgical Treatment of Chronic Subdural Hematoma. J Korean Neurosurg Soc. 2009 Aug; 46 (2): 87-92.
6. Gurelik M, Aslan A, Gurelik B, Ozum U, Karadag AÖ, Kars HZ. A safe and effective method for treatment of chronic subdural hematoma: The Canadian Journal of Neurological Sciences 2007; 34 (1): 84-7.
7. Erol FS, Topsakal C, Ozveren MF, Kaplan M, Tiftikci MT. Irrigation vs. closed drainage in the treatment of chronic subdural hematoma. Journal of Clinical Neuro-science 2005; 12 (3): 261-3.
8. Smely C., Madlngr A and Scheremet R. Chronic sub-dural hematoma- a comparison of two different treat-ment modalities. Acta Neurochir (Wein) 1997; 139: 818-26.
9. Zumofen D, RegliL, Levivier M, Krayenbühl N. Chro-nic subdural hematomas treated by burr hole trepana-tion and a subperiosteal drainage system. Neurosurgery 2009; 64 (6): 1116-21.
10. Engelhard III HH, Sinson GP, Reiter GT, Rohde V, Graf G and Hassler W. Complications of burr-hole cra-niostomy and closed-system drainage for chronic sub-dural hematomas: a retrospective analysis of 376 pati-ents Neurosurgical Review Springer Berlin / Heidelberg 2002; 25 (1-2).
11. Shaikh N, Masood I, Hanssens Y, Louon A, Hafiz A. Tension pneumocephalus as complication of burr-hole drainage of chronic subdural hematoma: A case report. Surg Neurol Int 2010; 1: 27.
12. Aung TH, Wong WK, Mo HP, Tsang CS. Management of chronic subdural hematoma: burr hole drainage, repl-acement with Hartmann’s solution and closed-system drainage HKMJ 1999; 5 (4): 383-6.
13. Kotwicaa, Brzeziskia Z J. Chronic subdural hematoma treated by burr holes and closed system drainage: Per-sonal experience in 131 patients. British Journal of Neurosurgery 1991; 5 (5): 461-5.
14. Robinson RG. Chronic subdural hematoma: surgical management in 133 patients. Journal of neurosurgery 1984; 61 (2): 263.
Downloads
Published
Issue
Section
License
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
