Avoiding pullout complications in external ventricular drains: technical note

J Neurosurg. 2017 Mar;126(3):1003-1005. doi: 10.3171/2016.2.JNS1678. Epub 2016 May 6.

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.

Keywords: EVD = external ventricular drain; complications; dislodgement; external ventricular drain; infection; surgical technique.

MeSH terms

  • Bandages, Hydrocolloid
  • Cerebral Ventricles / surgery
  • Child
  • Child, Preschool
  • Drainage / instrumentation*
  • Drainage / methods*
  • Equipment Failure
  • Female
  • Humans
  • Male
  • Operative Time
  • Postoperative Complications / prevention & control*
  • Retrospective Studies
  • Sutures
  • Treatment Outcome
  • Ventriculostomy / instrumentation*
  • Ventriculostomy / methods*