Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan-si, Korea.
Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-Ro, Guro-Gu, Seoul, 08308, Korea.
Neurosurg Rev. 2024 Sep 17;47(1):630. doi: 10.1007/s10143-024-02876-1.
This retrospective study endeavors to scrutinize risk factors associated with infections resulting from external ventricular drainage (EVD) and to assess the effectiveness of chlorhexidine dressing in mitigating infection rates. Conducted from January 2018 to July 2023, this single-center study encompassed 108 EVD patients. Comprehensive data on demographics, comorbidities, surgical procedures, and the utilization of chlorhexidine dressing were meticulously compiled. The primary endpoint was the incidence of EVD-associated infections based on CDC criteria. Infection rates attributable to EVD were 24.32% without and 20.59% with chlorhexidine dressing. Notably, diabetes mellitus emerged as the solitary significant infection risk factor (p < 0.01). Although the application of chlorhexidine dressing suggested a propensity for diminishing infection rates, statistical significance remained elusive. No notable disparities were discerned in variables such as catheter type, procedural location, and underlying diseases. Diabetes mellitus has been identified as a significant risk factor for EVD-associated infections. While the utilization of chlorhexidine dressing exhibited a potential reduction in infection rates, the lack of statistical significance underscores the imperative for further research, encompassing more expansive randomized trials, to comprehensively evaluate the safety and efficacy of chlorhexidine dressings in preventing EVD-associated infections.
这项回顾性研究旨在探讨与外部脑室引流(EVD)相关感染的风险因素,并评估氯己定敷料在降低感染率方面的效果。该研究于 2018 年 1 月至 2023 年 7 月在单中心进行,共纳入 108 例 EVD 患者。详细收集了人口统计学、合并症、手术程序以及氯己定敷料使用情况等综合数据。主要终点是根据 CDC 标准评估 EVD 相关感染的发生率。未使用氯己定敷料的感染率为 24.32%,使用氯己定敷料的感染率为 20.59%。值得注意的是,糖尿病是唯一显著的感染危险因素(p<0.01)。尽管氯己定敷料的应用表明有降低感染率的趋势,但统计学意义仍不明显。导管类型、操作部位和基础疾病等变量没有明显差异。糖尿病是 EVD 相关感染的一个重要危险因素。虽然氯己定敷料的使用显示出降低感染率的潜力,但缺乏统计学意义突显了进一步研究的必要性,包括更广泛的随机试验,以全面评估氯己定敷料预防 EVD 相关感染的安全性和有效性。