The usefulness of surgical drains on short term outcomes among patients undergoing craniotomy at the Bugando Medical Centre, Mwanza, Tanzania (Record no. 18604)
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| 000 -LEADER | |
|---|---|
| fixed length control field | 06366nam a22004457a 4500 |
| 001 - CONTROL NUMBER | |
| control field | CUHAS/MMED/6000274/T/18 |
| 003 - CONTROL NUMBER IDENTIFIER | |
| control field | CUHAS/MMED/6000274/T/18 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20240423151443.0 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 221209b |||||||| |||| 00| 0 eng d |
| 028 ## - PUBLISHER OR DISTRIBUTOR NUMBER | |
| Source | Wurzburg Road 35, BMC Premises, Post Code: 33102: |
| Source | P. O Box 1464, Mwanza – Tanzania: |
| Source | Phone: +255 28 298 3384: |
| Source | Fax: +255 28 298 3386 |
| Source | Email: vc@bugando.ac.tz |
| Source | Website: www.bugando.ac.tz |
| 035 ## - SYSTEM CONTROL NUMBER | |
| System control number | CUHAS/MMED/6000274/T/18 |
| 040 ## - CATALOGING SOURCE | |
| Language of cataloging | English |
| Transcribing agency | ddc |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | English |
| 100 ## - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Dennis Otwori Onsombi |
| Dates associated with a name | [Male] |
| 9 (RLIN) | 47161 |
| Relator term | CUHAS/MMED/6000274/T/18 |
| 210 ## - ABBREVIATED TITLE | |
| Abbreviated title | ABBREVIATIONS |
| Qualifying information | BMC - Bugando Medical Centre CRP - C Reactive Protein CSDH - Chronic Subdural hematoma CSF - Cerebrospinal fluid DG - Drain Group ED - Epidural hematoma LOS - Length of hospital stay NDG - Non Drain Group RCT - Randomized controlled trial SDD - Subdural Drain SFC - Subgaleal Fluid collection SOPD - Surgical Outpatient Department SPD - Subperiosteal drain SSI - Surgical Site Infection STATA - South Texas Art Therapy Association TBI - Traumatic Brain Injury USS - Ultrasonography |
| 222 ## - KEY TITLE | |
| Key title | STANDARD DEFINITIONS |
| Qualifying information | Surgical Site Infection: a)Purulent discharge from a surgical incision, b)organism identification by culture from fluid or tissue obtained aseptically, c)incision that dehisces spontaneously or deliberately opened by the surgeon, localized pain or tenderness, localized inflammation(heat, erythema and swelling) and/or fever>38 within 30days |
| Key title | STANDARD DEFINITIONS |
| Qualifying information | Subgaleal Fluid Collection: denotes an extracranial accumulation of fluid either csf, blood or hematogenous csf occurring between the scalp aponeurosis and the periosteum |
| Key title | STANDARD DEFINITIONS |
| Qualifying information | Neurological deficit: will encompass pupil size, symmetry and response to light. Impaired movement in any of the extremities |
| Key title | STANDARD DEFINITIONS |
| Qualifying information | Wound dehiscence: spontaneous or iatrogenic separation of sutured edges requiring drainage of a small amount of serous discharge or pus |
| Key title | OPERATIONAL DEFINITIONS |
| Qualifying information | Short term outcomes: Occurrence of subgaleal fluid collection, surgical site infection and length of hospital stay within 30 days of craniotomy |
| Key title | OPERATIONAL DEFINITIONS |
| Qualifying information | Surgeon: is termed as a doctor with a medical degree performing operations on patients |
| Key title | OPERATIONAL DEFINITIONS |
| Qualifying information | Subperiosteal drain (SPD), Subdural drain (SDD): improvised intravenous giving set attached to an empty Normal saline bottle which is collapsed, rolled and attached to iv tubing spike and then released to create suction for the drain placed in either the subperiosteal or subdural space |
| Key title | OPERATIONAL DEFINITIONS |
| Qualifying information | Preoperative length of stay: Interval between date of admission and the date of the surgical operation |
| Key title | OPERATIONAL DEFINITIONS |
| Qualifying information | Length of hospital Stay: will be defined as the interval between the date of surgical operation to the date of discharge |
| 245 ## - TITLE STATEMENT | |
| Title | The usefulness of surgical drains on short term outcomes among patients undergoing craniotomy at the Bugando Medical Centre, Mwanza, Tanzania |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Place of publication, distribution, etc. | Mwanza, Tanzania: |
| Name of publisher, distributor, etc. | Catholic University of Health and Allied Sciences [CUHAS – Bugando] : |
| Date of publication, distribution, etc. | 2022 |
| 300 ## - PHYSICAL DESCRIPTION | |
| Extent | x; 75 Pages |
| Extent | Includes References and Appendices |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Abstract:<br/><br/>Background: Postcraniotomy surgical drain placement is commonly used worldwide after various cranial surgical interventions despite the controversy surrounding their use leaving it to the surgeon’s preference rather than evidence based practice. However, with the paucity of published data regarding utility in Tanzania, we sought out to determine the occurrence of SFC, incidence of SSI and the length of hospital stay among patients who underwent craniotomies<br/><br/>Methods: This was a prospective cohort study conducted to determine the occurrence of SFC, rate of SSI and the length of hospital stay among patients who underwent craniotomies at BMC from Feb to June 2022. Patients were divided into two groups based on whether or not have undergone placement of drainage tube following craniotomy and data was collected, entered into Epi-Info version 7.0, extracted as Microsoft-Excel and analyzed using STATA v.13.0 software. Medians and proportions were utilized to describe data, and appropriate statistical tests applied whenever necessary to check for statistical significance. Ethical clearance was sought from the institution board to proceed with the study.<br/><br/>Results: A total of 77 patients were enrolled into the study, the median patient age (IOR) was 33(18 -55) years, and 55% of patients were males, giving male to female ratio of 2:1. Postcraniotomy drains were used in 36.36 %( 28/77) of the patients. Of the craniotomy procedures 52(67.5%) were due to trauma. Surgical site infection was encountered in 4 patients (5.2%), subgaleal fluid collection among 11 patients (14.28%) although this was not significant among the two groups on univariate analysis p=0.538 and 0.624 respectively. The length of hospital stay was similar in both drainage and non-drainage groups (p=0.498). In a bivariate analysis on drain use vs patient factors, dural closure (P value= <0.001), skin closure (P value= <0.001) and cormobidities (p value=0.013), for which on further multivariate regression, watertight dural closure (p=0.015, OR 14.15 ) was found to be associated with less likelihood of drainage use.<br/><br/>Conclusion: In this single center observational study, we noted that outcomes of patients with post-craniotomy drains were largely equivalent and non-inferior to those without drains who underwent craniotomy for similar neurosurgical conditions at our institution with no statistical significance in terms of occurrence of subgaleal fluid collection, incidence of surgical site infection and length of hospital stay. The use of watertight dura closure significantly reduces the occurrence of SFC. Larger well randomized control and multicentered studies are recommended to further validate our findings.<br/> |
| 600 ## - SUBJECT ADDED ENTRY--PERSONAL NAME | |
| General subdivision | General Surgery |
| 9 (RLIN) | 29082 |
| General subdivision | Neurosurgery |
| 700 ## - ADDED ENTRY--PERSONAL NAME | |
| 9 (RLIN) | 30265 |
| 9 (RLIN) | 30721 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | ddc |
| Koha item type | POSTGRADUATE DISSERTATIONS |
| Withdrawn status | Lost status | Source of classification or shelving scheme | Damaged status | Not for loan | Collection | Home library | Current library | Shelving location | Date acquired | Total checkouts | Barcode | Date last seen | Copy number | Price effective from | Koha item type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | 12/09/2022 | CREC/538/2022 | 12/09/2022 | CREC/538/2022 | 12/09/2022 | POSTGRADUATE DISSERTATIONS |