Evidence map›Paper›PMID 31940095›Full record

Observational studyActa neurochirurgica2020

Surgical nuances and placement of subgaleal drains for supratentorial procedures-a prospective analysis of efficacy and outcome in 150 craniotomies.

Hussam Aldin Hamou, Konstantin Kotliar, Sonny Kian Tan, Christel Weiß, Blume Christian, Hans Clusmann, Gerrit Alexander Schubert, Walid Albanna

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Acta neurochirurgica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Hussam Aldin HamouDepartment of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Konstantin KotliarDepartment of Medical Engineering and Technomathematics, FH Aachen University of Applied Sciences, Aachen, Germany.
Sonny Kian TanDepartment of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Christel WeißDepartment for Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Blume ChristianDepartment of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Hans ClusmannDepartment of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Gerrit Alexander Schubert *Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Walid Albanna *Department of Neurosurgery, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. walidalbanna@yahoo.de.ORCID http://orcid.org/0000-0001-9986-8739
RWTH Aachen University · DEFH Aachen · DEHeidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set.

methodWe prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up.

resultsEarly subgaleal fluid collection was observed in 36.7% (2.8% at the late follow-up), and impaired wound healing was recorded in 3.3% of all cases, with an overall need for operative revision of 6.7%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05).

conclusionsBased on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design.

Indexed as

AdultAgedCerebrospinal Fluid LeakCraniotomyDrainageFemaleFollow-Up StudiesHumansMaleMiddle AgedNeurosurgical ProceduresPostoperative ComplicationsProspective StudiesReoperationSupratentorial NeoplasmsTreatment OutcomeCraniotomyCSF fistula/leakDural closureInfectionSubgaleal drainage

Identifiers

PMID31940095
PMCPMC7066100
OpenAlexW2999718649

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.