title: Avoiding pullout complications in external ventricular drains: technical note.
abstract: This report describes a reliable and simple technique for securing external ventricular drains (EVDs) to the scalp and avoiding pullout complications. The operative technique consists of fixing the drain between 2 hydrocolloid dressings and securing it with staples. A 10-year retrospective analysis of EVD pullout complications was performed in a series of 435 consecutive patients who were treated at a single institution. The EVD pullout complication rate was 0.4%. No complications related to the fixation technique were found. The median operative time required to fix the drain was 60 seconds. The technique presented here is a simple and reliable procedure to fix the EVD to the scalp, preventing pullout complications and thus reducing the morbidity of EVD reimplantation.
authors.affiliation: Department of Neurological Surgery and Spine Unit, Hospital Universitario Marqués de Valdecilla and Fundación Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander.
authors.forename: Carlos
authors.initials: C
authors.lastname: Velásquez
authors.affiliation: Department of Neurosurgery.
authors.forename: Mónica
authors.initials: M
authors.lastname: Rivero-Garvía
authors.affiliation: Department of Pediatric Anesthesia, and.
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Mayorga-Buiza
authors.affiliation: Department of Neurosurgery, Complejo Hospitalario de Toledo, Spain.
authors.forename: María de Los Ángeles
authors.initials: ML
authors.lastname: Cañizares-Méndez
authors.affiliation: Infectious Disease Unit, Hospitales Universitarios Virgen del Rocio, Seville; and.
authors.forename: Manuel E
authors.initials: ME
authors.lastname: Jiménez-Mejías
authors.affiliation: Department of Neurosurgery.
authors.forename: Javier
authors.initials: J
authors.lastname: Márquez-Rivas
mesh_terms: D047070:Bandages, Hydrocolloid; D002552:Cerebral Ventricles / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000295:instrumentation* / Q000379:methods*
keywords: EVD = external ventricular drain; complications; dislodgement; external ventricular drain; infection; surgical technique