Vaccum drainage system application in the management of operation-related non-regional epidural hematoma

Abstract

BackgroundEpidural intracranial hematoma is one of the most common complications of surgeries for intracranial tumors. The non-regional epidural hematoma is related to severe fluctuation of the intracranial pressure during the operation. The traditional management of hematoma evacuation through craniotomy is time-consuming and may aggravate intracranial pressure imbalance, which causes further complications. We designed a method using vaccum epidural drainage system, and tried to evaluate advantage and the disadvantage of this new technique.MethodsSeven patients of intracranial tumors were selected. All of the patients received tumor resection and intra-operative non-regional epidural hematoma was confirmed through intra-operative ultrasound or CT scan. The vaccum drainage system was applied. Another ten patients who received craniotomy for intra-operative non-regional epidural hematoma evacuation were selected as comparison. Regular tests, like serial CT scan, were performed afterward to evaluate the effectiveness and to help deciding when to remove the drainage system.ResultsThe vaccum drainage method was effective in epidual hemotoma clearance and prevented recurrent epidural hemorrhage. The drainage systems were removed within 4 days. All of the patients recovered well. No complications related to the drainage system were observed.ConclusionsCompared to the traditional craniotomy, the new method of epidural hemoatoma management using vaccum epidural drainage system proved to be as effective in hematoma clearance, and was less-invasive and easier to perform, with less complication, shorter hospitalization, less economic burden, and better prognosis.

The usefulness of surgical drains on short term outcomes among patients undergoing craniotomy at the Bugando Medical Centre, Mwanza Tanzania

“…1 Historically, since Hippocrates times, the use of surgical drains have been reported in a wide variety of surgical procedures throughout the body although their efficacy and safety has been a question of debate in different disciplines 2 , 3 , 4 , 5 , 6 Similarly, regarding post craniotomy drains, some neurosurgeons use them post craniotomy, others do not and there exists no concensus on the use of the drains. 7 , 8 The necessity of post craniotomy drains on post-operative outcomes such as surgical site infection, prolonged hospital stay and subgaleal fluid collection has been studied by several groups with inconsistent results with some reporting advantages, 9 , 10 , 11 , 12 other groups paradoxically reported surgical complications 13 , 14 , 15 , 16 and the neutral arm which found no difference with the use of drains 17 , 18 , 19 …”