title: Current practice of external ventricular drainage: a survey among neurosurgical departments in Germany.
abstract: BACKGROUND
  There are various recommendations, but no generally accepted guidelines, to reduce the risk of external ventricular drainage (EVD)-associated infections. The primary objective of the present study was to evaluate the current practice of EVD in a European country and to set the results in perspective to published data.
  
  
  METHODS
  A standardised questionnaire prepared by the Commission of Technical Standards and Norms of the German Society of Neurosurgery was sent to 127 neurosurgical units in Germany.
  
  
  RESULTS
  Data were analysed from 99 out of 127 neurosurgical units which had been contacted. Overall, more than 10,000 EVD procedures appear to be performed in Germany annually. There is disagreement about the location where the EVD is inserted, and most EVDs are still inserted in the operation theatre. Most units apply subcutaneous tunnelling. Impregnated EVD catheters are used regularly in only about 20 % of units. Single-shot antibiotic prophylaxis is given in more than half of the units, while continued antibiotic prophylaxis is installed in only 15/99 units at a regular basis. There are discrepancies in the management of prolonged EVD use with regard to replacement policies. Regular cerebrospinal fluid (CSF) sampling is still performed widely. There were no statistical differences in policies with regard to academic versus non-academic units.
  
  
  CONCLUSIONS
  This survey clearly shows that some newer recommendations drawn from published studies penetrate much slower into clinical routine, such as the use of impregnated catheters, for example. It remains unclear how different policies actually impact quality and outcome in daily routine.
authors.affiliation: Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany. Cinibulak.Zafer@mh-hannover.de.|Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany. Cinibulak.Zafer@mh-hannover.de.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Cinibulak
authors.affiliation: Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany.|Department of Neurosurgery, University of Heidelberg, Heidelberg, Germany.
authors.forename: Alfred
authors.initials: A
authors.lastname: Aschoff
authors.affiliation: Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany.
authors.forename: Anani
authors.initials: A
authors.lastname: Apedjinou
authors.affiliation: Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany.|Department of Neurosurgery, Sankt Gertrauden Hospital, Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kaminsky
authors.affiliation: Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany.|Department of Neurosurgery, Bayreuth Hospital, Bayreuth, Germany.
authors.forename: Hans A
authors.initials: HA
authors.lastname: Trost
authors.affiliation: Department of Neurosurgery, Medical School Hannover, Carl-Neuberg Str. 1, 30625, Hannover, Germany.|Commission of Technical Standards and Norms, German Society of Neurosurgery, Messe-Allee 1, 04356, Leipzig, Germany.
authors.forename: Joachim K
authors.initials: JK
authors.lastname: Krauss
mesh_terms: D019072:Antibiotic Prophylaxis; D004322:Drainage / Q000379:methods*; D005060:Europe; D005858:Germany; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D011795:Surveys and Questionnaires
keywords: Infection; Neurosurgery; Survey; Technique; Ventricular drainage