J Cerebrovasc Endovasc Neurosurg.  2015 Sep;17(3):194-202. 10.7461/jcen.2015.17.3.194.

Necessity of Surgical Site Closed Suction Drain for Pterional Craniotomy

• Choi SY
• Yoon SM
• Yoo CJ
• Park CW
• Kim YB
• Kim WK

• KMID: 2069243
• DOI: http://doi.org/10.7461/jcen.2015.17.3.194

Abstract

OBJECTIVE
The aim of this study was to assess the benefit of using a prophylactic surgical site closed suction drain in pterional craniotomy.
MATERIALS AND METHODS
A retrospective review was conducted on 607 consecutive patients who underwent a pterional craniotomy for treatment of intracranial anterior circulation aneurysms over a 5-year period. Between January 2000 and December 2004, 607 patients were divided into two groups, those who had a prophylactic suction drain during closure of the surgical site (drain group, DG) and those who did not (non-drain group, NDG). Head computed tomography (CT) was taken routinely on postoperative day (POD) 1, 7, and 14. Patients' demographics, incidence of surgical site complications, and courses of surgical site healing which were evaluated radiologically by the thickness of the surgical site myocutaneous layer, were analyzed between DG and NDG.
RESULTS
Patients' demographics and characteristics did not differ significantly between the two groups. The head CT showed that the degree of changes in the postoperative surgical site thickness was 148% at POD 1, 209% at POD 7, and 198% at POD 14 in DG, and 118% at POD 1, 152% at POD 7, and 158% at POD 14 in NDG compared to the preoperative value. Postoperative surgical site hematoma was 7.9% (22/274) in DG and 2.4% (8/333) in NDG.
CONCLUSION
Prophylactic use of an epidural and/or subgaleal closed suction drain does not appear to be necessary for prevention of postoperative surgical site hematoma as well as for promotion of surgical site healing in pterional craniotomy.

Keyword

Craniotomy; Drainage; Surgical wound infection

MeSH Terms

Aneurysm
Craniotomy*
Demography
Drainage
Head
Hematoma
Humans
Incidence
Retrospective Studies
Suction*
Surgical Wound Infection

Figure

• 

  Fig. 1 Thickness of myocutaneous layer (in mm) from the surface of the skull to that of the scalp on the pterional craniotomy site at or just above the level of zygomatic arch on the head CT slice. A: Preoperative thickness of myocutaneous layer (a). B: Postoperative 7 day's thickness of myocutaneous layer (b). Postoperative thickness of myocutaneous layer value ; (b/a) × 100 (%).

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