Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
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The efficacy of surgical site suction drain insertion in pterional craniotomy for intracranial cerebral aneurysm

  • Hong Bum Kim (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jung Cheol Park (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jae Sung Ahn (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Seungjoo Lee (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kuhyun Yang (Department of Neurosurgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Wonhyoung Park (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2023.06.27
  • Accepted : 2024.02.07
  • Published : 2024.09.30
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Abstract

Objective: We evaluated the role of subgaleal closed suction drains in postoperative epidural hematoma (EDH) and wound complications following pterional craniotomy for cerebral aneurysm. Methods: We reviewed 5,280 pterional craniotomies performed on 5,139 patients between January 2006 and December 2020. A drain was placed subgalealy and tip of drain was positioned between the bone flap and the deep temporalis. 1,637 cases (31%) had a subgaleal suction drain. We analyzed demographic and clinical variables related to EDH requiring evacuation and wound complications in patients with and without drains. Univariate and multivariate logistic regression analyses were performed to determine the associated risk factors. Results: Fourteen cases (0.27%) of EDH requiring evacuation and 30 cases (0.57%) of wound complications were identified. Univariate analysis found that drain insertion, subarachnoid hemorrhage (SAH), and operation time were associated with EDH, while drain insertion, SAH, male gender, older age, and longer operation time were associated with wound complications. Multivariate analysis found no significant association between drain use and EDH (OR=1.62, p=0.402) or wound complications (OR=1.45, p=0.342). Conclusions: Routine use of subgaleal closed suction drains may not be necessary after pterional craniotomy, as drain insertion was not associated with a reduced risk of EDH requiring evacuation or wound complications.

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References

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