Vacuum-assisted closure (VAC) for craniocerebral wounds in severely injured patients: technical note of a damage control procedure

Joubert, Christophe; Sellier, Aurore; Morvan, J.-B.; Beucler, Nathan; Bordes, Julien; Dagain, Arnaud

doi:10.1136/jramc-2019-001201

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…[10,17] In addition, tetanus prophylaxis should be performed associated with prophylactic antibiotics and anticonvulsive therapy. [8,23] The standard surgical treatment of intracranial hypertension is external ventricular drainage (EVD). If intracranial pressure is high despite EVD, the damaged frontal or temporal lobe can be partially excised or a decompressive craniectomy may be performed.…”

Section: Duraplasty 12mentioning

confidence: 99%

“…[1][2][3][4][5] Especially in recent years, the increasing incidents of violence, civil wars and terrorism in cities have made CGW even more important. [6][7][8][9] These injuries are the most lethal form of all firearm injuries, and the treatment principles are still controversial. [10,11] Minimal invasive approaches are suggested by many authors, while aggressive surgical methods are also advocated to prevent the mortality of patients.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Kirik

Yaşar

Durmaz

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Craniocerebral gunshot wounds (CGW) are the most lethal injuries of the cranium. CGW is mostly secondary to military conflicts but may also be seen in civilian life. These injuries also have severe consequences, such as epilepsy, hydrocephalus, infection and late-term cognitive dysfunctions. The present study aims to present our series of CGW and to discuss the prognostic factors and consequences of these injuries. METHODS:The data of patients who were treated in our department for CGW between 2011 and 2019 were retrospectively reviewed in this study. The injury type, wounding site, surgical management and outcomes were analyzed. Radiological evaluation was also performed. RESULTS:Thirty patients were treated with the diagnosis of CGW. All of the patients were male and the mean age was 27.9 years. The frontal lobe was affected in 12 (40%) patients, while temporal lobe in eight, occipital lobe in six, parietal lobe in three, and posterior fossa in one patients. Twenty-three patients underwent surgical treatment, seven patients were treated conservatively. Thirteen (43.3%) patients died despite the treatment. CONCLUSION:Mortality in CGW is high. Ventricular injuries, bihemispheric or midline injuries, perforating injuries, brain stem injuries and low GCS score at admission are prognostic factors for CGW. Appropriate management is mandatory to obtain a better clinical outcome.

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Section: Duraplasty 12mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Kirik

Yaşar

Durmaz

2020

Ulus Travma Acil Cerrahi Derg

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“…Severe craniocerebral injury is a common clinical condition with complexities and complications, and epidemiological reports suggest that the morbidity and mortality rate of severe craniocerebral injury as high as 45% (1,2). Conventional surgery is the most common clinical treatment for severe craniocerebral injury, but postoperative patients are prone to cerebrospinal fluid leakage.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis of the efficacy and safety of cerebrospinal fluid drainage and lumbar puncture in the treatment of cerebrospinal fluid leakage after craniocerebral injury

Su¹,

Lv²,

Dai³

2023

Ann Palliat Med

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Background: Commonly used clinical treatments for intracranial hypertension include continuous lumbar cerebrospinal fluid drainage (CLCFD) and conventional lumbar puncture. However, lumbar puncture is more invasive, requires multiple punctures. CLCFD has less trauma, and drainage can be manipulated to avoid repeated lumbar puncture. However, CLCFD may also lead to complications such as intracranial hematoma and intracranial pneumothorax. Therefore, there is no agreement on which method is more effective. This study evaluated the efficacy of CLCFD and conventional lumbar puncture in the treatment of cerebrospinal fluid leakage after craniocerebral injury. Methods: The search terms 'brain injury' and 'CLCFD' were used to search CNKI, Wanfang, VIP, Longyuan, PubMed, Embase, Cochrane Library and other databases (from inception to November 1, 2022). Inclusion criteria: (I) randomized controlled trials (RCTs), CLCFD and conventional lumbar puncture drainage for patients with cerebrospinal fluid leakage after craniocerebral injury; (II) evaluation of indicators such as cerebrospinal fluid leakage stop time, clearance time, intracranial infection and complications.Cochrane systematic review was performed to assess the quality of the literature. RevMan 5.3 software was used for systematic analysis.Results: A total of 8 studies, involving 568 patients. There is some publication bias in the statistics.The cessation time of cerebrospinal fluid leakage (95% confidence interval (CI): −3.65 to −2.86, Z=16.21, P<0.00001), the time to return to normal pressure (95% CI: −3.13 to −2.09, Z=9.79, P<0.00001), cerebrospinal fluid clearing time (95% CI: −1.96 to −1.09, Z=6.91, P<0.00001), hospitalization time (95% CI: −1.99 to −0.91, Z=5.27, P<0.00001), incidence of intracranial infection (95% CI: 0.07-0.27, Z=5.84, P<0.00001) and complications (95% CI: 0.10-0.43, Z=4.22, P<0.0001) in the CLCFD group were lower than those in the conventional group. The cure rate of the CLCFD group was significantly higher than that of the conventional group (OR =3.75, 95% CI: 2.26-6.23, Z=5.11, P<0.00001); the difference in mortality between the two groups was not statistically significant (P>0.05).Conclusions: Compared with conventional lumbar puncture, CLCFD can significantly increase the cure rate, shorten the recovery time of cerebrospinal fluid, and significantly reduce the incidence of intracranial infections, reduce complications, is conducive to the prognosis of patients.

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Neuro damage control: current concept and civilian applications

Manet,

Joubert,

Balanca

et al. 2023

Neurochirurgie

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Vacuum-assisted closure (VAC) for craniocerebral wounds in severely injured patients: technical note of a damage control procedure

Cited by 5 publications

References 15 publications

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Prognostic Factors in Craniocerebral Gunshot Wounds: Analysis of 30 Patients from the Neurosurgical Viewpoint

Systematic review and meta-analysis of the efficacy and safety of cerebrospinal fluid drainage and lumbar puncture in the treatment of cerebrospinal fluid leakage after craniocerebral injury

Neuro damage control: current concept and civilian applications

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