EFFECT OF TUNNEL LENGTH ON INFECTION RATE IN PATIENTS WITH EXTERNAL VENTRICULAR DRAIN
AbstractBackground: External ventricular drain involves catheter placement in ventricles of brain. It is usedfor various purposes. Basic theme is to drain cerebrospinal fluid so as to control intracranial pressure.This study was carried out to see the effect of tunnel length on rate of infection. Methods: This wasa cross-sectional study carried out in Department of Neurosurgery, Pakistan Institute of MedicalSciences, Islamabad during 14 months from 1st December 2008 to 31st January 2010. Externalventricular drain was placed in admitted patients after meticulous aseptic technique in operationtheatre at right Kocher’s point. It was carried out through a scalp tunnel and was connected todrainage bag through a drip set. Both long (more than 5 Cm) and short (<5 Cm) tunnels wererandomly made. Infection rate was estimated in patients who had change of cerebrospinal fluidcolour or developed fever (as per protocol to have minimum handling of drain). All patients receivedprophylactic Ceftriaxone. Results: Among 76 patients long tunnel was made in 44 (57.9%) and shortin 32 (42.1%). Three patients (3.9%) with long tunnel while 6 (7.9%) patients with short tunnel hadinfection. The overall infection was in 9 (11.8%) patients. Conclusion: External ventricular draintunnel length strongly influences the rate of infection.Keywords: External ventricular drain, tunnel length, infection, cerebrospinal fluid, hydrocephalous,intracranial pressure
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