Subpericranial shunt valve placement: a technique in patients with friable skin

Bot, Gyang Markus; Ismail, Nasiru Jinjiri; Usman, Babagana; Shilong, Danaan J.; Obande, JO; Aliu, Salamat O.; Hassan, Ismail; Shehu, BB

doi:10.1007/s00381-014-2433-4

Cited by 12 publications

(13 citation statements)

References 4 publications

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“…This is consistent with Abdul Munam et al who conducted their study on 40 VP shunt complicated patients where children represented 85% [19]. In neonates, scalp necrosis is actually a common complication associated with VP shunts which is due to the inherent skin fragility and the superficial nature of the shunt [20,21]. In agreement with this current study scalp, necrosis was presented in four (13.3%) patients.…”

Section: Discussionsupporting

confidence: 91%

Ventriculoperitoneal shunt complications: a local study at Qena University Hospital: a retrospective study

Hamdan

2018

Egypt J Neurosurg

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Background: Shunting of cerebrospinal fluid (CSF) has reduced the morbidity and mortality of hydrocephalus. Ventriculoperitoneal (VP) shunt is the most commonly used procedure for shunting, but it has potential complications that may need multiple surgical interventions. Methods: It is a clinical retrospective observational study that was conducted on 30 patients of both genders with different ages who presented with signs and symptoms of shunt malfunction between 2012 and 2016. A complete clinical assessment was done, a final diagnosis was made, and a treatment of individual patients was planned accordingly. Patients were followed up within 1 week and 1 month post-operatively. Data was analyzed using the SPSS (version 16.0). Results: VP shunt was inserted for 205 patients. Thirty (14.6%) patients had various forms of complications. Fifteen (50%) patients had complications related to the proximal catheter and the reservoir while 15 (50%) patients had complications related to distal catheter. The most common complications were exposure of the shunt 23.3% (13.3% exposed shunt reservoir and 10% exposed distal catheter) followed by shunt obstruction 13.3% (6.66% proximal and 6.66% distal). Twentyeight (93.3%) patients were managed surgically, 24 (85%) patients of them showed marked improvement at the end of the first month postoperatively, while four (15%) patients needed another surgical intervention. Conclusions: Insertion of V-P shunt is routinely done by all neurosurgeons. A great care should be taken during insertion of the shunt system starting from scrubbing to avoid complications. Despite complications, the VP shunt remains the main surgical procedure used for hydrocephalus management.

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Section: Discussionsupporting

confidence: 91%

Ventriculoperitoneal shunt complications: a local study at Qena University Hospital: a retrospective study

Hamdan

2018

Egypt J Neurosurg

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“…17 In neonates, scalp necrosis is a common complication associated with repeated VP shunts due to the inherent skin fragility and the superficial nature of the shunt. 18,19 Peacock and Currer found shunt blockage in 20% of their patients. 20 Mwan'gombe and Omulo reported an infection rate of 24.6% among children operated for nontumor hydrocephalus in Nairobi.…”

Section: Discussionmentioning

confidence: 96%

A Retrospective Study on Ventriculoperitoneal Shunt Complications in a Tertiary Care Centre

Kumar

Pandey

Bhakal

et al. 2020

Indian Journal of Neurosurgery

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Background Ventriculoperitoneal shunt (VPS) is a common technique employed to treat the second most common congenital brain malformation, “hydrocephalus.” Postshunt insertion, the consequent complications and factors contributing to shunt malfunction are much fought occurrences. The current study was planned to assess the effectiveness of the procedure, analyze the complications of VP shunt, and recognize the factors influencing shunt malfunction. Materials and Methods The present study was a retrospective observational study, which was conducted at the Department of Neurosurgery, PGIMER RML Hospital, New Delhi, from August 2016 to July 2018. Patients with hydrocephalus requiring shunt intervention were included in the study. A Chhabra “slit n spring” hydrocephalus shunt system was inserted in all patients. All patients with VP shunts were followed to assess for any postshunt complications. Results Out of 541 patients for whom VP shunt was inserted over a period of 2 years, 126 (23.3%) patients developed complications. The most common cause of hydrocephalus for which VP shunt was done was tubercular meningitis (39.3%, n = 63), followed by ventriculitis (12.38%, n = 20), congenital hydrocephalus (8.87%, n = 14) and aqueductal stenosis (5.54%, n = 03). The most common complication in our study was obstruction of proximal end of the catheter by debris, which was noted in 50 patients (39.68%). The second most common complication was poor peritoneal absorption or obstruction of lower end (21.43%, n = 27 cases). Abscess along the shunt was seen in 21 patients (16.67%). Complications were mostly documented in cases with hydrocephalus due to tubercular meningitis (TBM) (39.3%, 63 patients) and ventriculitis (12.38%, 20 patients). Other complications were hyperemia with superficial ulceration or complete exposure of skin overlying the tube (11.9%, n = 15), overdrainage of the ventricles leading to chronic subdural hematoma (n = 14, 11.11%), and infection around the distal catheter (4.76%, n = 6). Conclusion VPS procedure led to a complication in several patients, with the most common being obstruction of proximal catheter and poor peritoneal absorption or obstruction of lower end followed by abscess and infection.

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“…Patients with fragile skin are particularly predisposed to wound dehiscence, exposed shunt and poor wound recovery (1,2).…”

Section: █ Discussionmentioning

confidence: 99%

“…The patients with fragile skin are at risk of having a cerebrospinal fluid (CSF) fistula of the surgical wound, wound dehiscence, and skin breakdown over shunt hardware or an exposed shunt valve ( Figure 1). If these occur, the shunt may need to be replaced, which causes ugly skin scars, increasing morbidity and even mortality (2,3). Moreover, in patients Shunt systems are not perfect devices and can cause severe complications.…”

Section: █ Introductionmentioning

confidence: 99%

“reverse j shaped” skin flap and cranial bone groove for shunt hardware: a new technique in patients with fragile skin

Çakır

2017

Turkish Neurosurgery

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Subpericranial shunt valve placement: a technique in patients with friable skin

Cited by 12 publications

References 4 publications

Ventriculoperitoneal shunt complications: a local study at Qena University Hospital: a retrospective study

Ventriculoperitoneal shunt complications: a local study at Qena University Hospital: a retrospective study

A Retrospective Study on Ventriculoperitoneal Shunt Complications in a Tertiary Care Centre

“reverse j shaped” skin flap and cranial bone groove for shunt hardware: a new technique in patients with fragile skin

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