Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)

Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cr...
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Autor*in:	Sam, Jo Ee [verfasserIn] Kandasamy, Regunath [verfasserIn] Wong, Albert Sii Hieng [verfasserIn] Ghani, Abdul Rahman Izaini [verfasserIn] Ang, Song Yee [verfasserIn] Idris, Zamzuri [verfasserIn] Abdullah, Jafri Malin [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma

Übergeordnetes Werk:	Enthalten in: World neurosurgery - Amsterdam : Elsevier, 2010, 156, Seite e381-e391
Übergeordnetes Werk:	volume:156 ; pages:e381-e391

DOI / URN:	10.1016/j.wneu.2021.09.074

Katalog-ID:	ELV006945090

Internformat


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100	1		\|a Sam, Jo Ee \|e verfasserin \|4 aut
245	1	0	\|a Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
264		1	\|c 2021
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520			\|a Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.
650		4	\|a Complications
650		4	\|a Decompressive craniectomy
650		4	\|a Functional outcome
650		4	\|a Mortality
650		4	\|a Postcraniectomy hydrocephalus
650		4	\|a Subgaleal drains
650		4	\|a Subgaleal hematoma
700	1		\|a Kandasamy, Regunath \|e verfasserin \|4 aut
700	1		\|a Wong, Albert Sii Hieng \|e verfasserin \|0 (orcid)0000-0001-5170-3345 \|4 aut
700	1		\|a Ghani, Abdul Rahman Izaini \|e verfasserin \|4 aut
700	1		\|a Ang, Song Yee \|e verfasserin \|4 aut
700	1		\|a Idris, Zamzuri \|e verfasserin \|4 aut
700	1		\|a Abdullah, Jafri Malin \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t World neurosurgery \|d Amsterdam : Elsevier, 2010 \|g 156, Seite e381-e391 \|h Online-Ressource \|w (DE-627)615134904 \|w (DE-600)2530041-6 \|w (DE-576)321461150 \|x 1878-8769 \|7 nnns
773	1	8	\|g volume:156 \|g pages:e381-e391
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936	b	k	\|a 44.90 \|j Neurologie
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Indexfelder

author_variant	j e s je jes r k rk a s h w ash ashw a r i g ari arig s y a sy sya z i zi j m a jm jma
matchkey_str	article:18788769:2021----::aumrisessasvdanvrundanidcmrsiernetmeaadmzdotoldraosb
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publishDate	2021
allfields	10.1016/j.wneu.2021.09.074 doi (DE-627)ELV006945090 (ELSEVIER)S1878-8750(21)01417-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Sam, Jo Ee verfasserin aut Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates. Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma Kandasamy, Regunath verfasserin aut Wong, Albert Sii Hieng verfasserin (orcid)0000-0001-5170-3345 aut Ghani, Abdul Rahman Izaini verfasserin aut Ang, Song Yee verfasserin aut Idris, Zamzuri verfasserin aut Abdullah, Jafri Malin verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 156, Seite e381-e391 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:156 pages:e381-e391 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 156 e381-e391
spelling	10.1016/j.wneu.2021.09.074 doi (DE-627)ELV006945090 (ELSEVIER)S1878-8750(21)01417-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Sam, Jo Ee verfasserin aut Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates. Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma Kandasamy, Regunath verfasserin aut Wong, Albert Sii Hieng verfasserin (orcid)0000-0001-5170-3345 aut Ghani, Abdul Rahman Izaini verfasserin aut Ang, Song Yee verfasserin aut Idris, Zamzuri verfasserin aut Abdullah, Jafri Malin verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 156, Seite e381-e391 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:156 pages:e381-e391 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 156 e381-e391
allfields_unstemmed	10.1016/j.wneu.2021.09.074 doi (DE-627)ELV006945090 (ELSEVIER)S1878-8750(21)01417-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Sam, Jo Ee verfasserin aut Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates. Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma Kandasamy, Regunath verfasserin aut Wong, Albert Sii Hieng verfasserin (orcid)0000-0001-5170-3345 aut Ghani, Abdul Rahman Izaini verfasserin aut Ang, Song Yee verfasserin aut Idris, Zamzuri verfasserin aut Abdullah, Jafri Malin verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 156, Seite e381-e391 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:156 pages:e381-e391 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 156 e381-e391
allfieldsGer	10.1016/j.wneu.2021.09.074 doi (DE-627)ELV006945090 (ELSEVIER)S1878-8750(21)01417-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Sam, Jo Ee verfasserin aut Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates. Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma Kandasamy, Regunath verfasserin aut Wong, Albert Sii Hieng verfasserin (orcid)0000-0001-5170-3345 aut Ghani, Abdul Rahman Izaini verfasserin aut Ang, Song Yee verfasserin aut Idris, Zamzuri verfasserin aut Abdullah, Jafri Malin verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 156, Seite e381-e391 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:156 pages:e381-e391 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 156 e381-e391
allfieldsSound	10.1016/j.wneu.2021.09.074 doi (DE-627)ELV006945090 (ELSEVIER)S1878-8750(21)01417-0 DE-627 ger DE-627 rda eng 610 DE-600 44.90 bkl Sam, Jo Ee verfasserin aut Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates. Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma Kandasamy, Regunath verfasserin aut Wong, Albert Sii Hieng verfasserin (orcid)0000-0001-5170-3345 aut Ghani, Abdul Rahman Izaini verfasserin aut Ang, Song Yee verfasserin aut Idris, Zamzuri verfasserin aut Abdullah, Jafri Malin verfasserin aut Enthalten in World neurosurgery Amsterdam : Elsevier, 2010 156, Seite e381-e391 Online-Ressource (DE-627)615134904 (DE-600)2530041-6 (DE-576)321461150 1878-8769 nnns volume:156 pages:e381-e391 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_165 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.90 Neurologie AR 156 e381-e391
language	English
source	Enthalten in World neurosurgery 156, Seite e381-e391 volume:156 pages:e381-e391
sourceStr	Enthalten in World neurosurgery 156, Seite e381-e391 volume:156 pages:e381-e391
format_phy_str_mv	Article
bklname	Neurologie
institution	findex.gbv.de
topic_facet	Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma
dewey-raw	610
isfreeaccess_bool	false
container_title	World neurosurgery
authorswithroles_txt_mv	Sam, Jo Ee @@aut@@ Kandasamy, Regunath @@aut@@ Wong, Albert Sii Hieng @@aut@@ Ghani, Abdul Rahman Izaini @@aut@@ Ang, Song Yee @@aut@@ Idris, Zamzuri @@aut@@ Abdullah, Jafri Malin @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	615134904
dewey-sort	3610
id	ELV006945090
language_de	englisch
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Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. 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author	Sam, Jo Ee
spellingShingle	Sam, Jo Ee ddc 610 bkl 44.90 misc Complications misc Decompressive craniectomy misc Functional outcome misc Mortality misc Postcraniectomy hydrocephalus misc Subgaleal drains misc Subgaleal hematoma Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
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topic_title	610 DE-600 44.90 bkl Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial) Complications Decompressive craniectomy Functional outcome Mortality Postcraniectomy hydrocephalus Subgaleal drains Subgaleal hematoma
topic	ddc 610 bkl 44.90 misc Complications misc Decompressive craniectomy misc Functional outcome misc Mortality misc Postcraniectomy hydrocephalus misc Subgaleal drains misc Subgaleal hematoma
topic_unstemmed	ddc 610 bkl 44.90 misc Complications misc Decompressive craniectomy misc Functional outcome misc Mortality misc Postcraniectomy hydrocephalus misc Subgaleal drains misc Subgaleal hematoma
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title	Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
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title_full	Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
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author_browse	Sam, Jo Ee Kandasamy, Regunath Wong, Albert Sii Hieng Ghani, Abdul Rahman Izaini Ang, Song Yee Idris, Zamzuri Abdullah, Jafri Malin
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title_sort	vacuum drains versus passive drains versus no drains in decompressive craniectomies–a randomized controlled trial on subgaleal drain complication rates (vader trial)
title_auth	Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
abstract	Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.
abstractGer	Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.
abstract_unstemmed	Objective: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.
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title_short	Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)
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author2	Kandasamy, Regunath Wong, Albert Sii Hieng Ghani, Abdul Rahman Izaini Ang, Song Yee Idris, Zamzuri Abdullah, Jafri Malin
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doi_str	10.1016/j.wneu.2021.09.074
up_date	2024-07-06T23:05:24.314Z
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Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.Methods: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.Results: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.Conclusions: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Complications</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Decompressive craniectomy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Functional outcome</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Mortality</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Postcraniectomy hydrocephalus</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Subgaleal drains</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Subgaleal hematoma</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kandasamy, Regunath</subfield><subfield code="e">verfasserin</subfield><subfield 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Vacuum Drains versus Passive Drains versus No Drains in Decompressive Craniectomies–A Randomized Controlled Trial on Subgaleal Drain Complication Rates (VADER Trial)

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