THE EFFECT OF SUBCUTANEOUS TUNNELING ON EXTERNAL LUMBAR DRAINAGE COMPLICATIONS

Year 2023, Volume: 12 Issue: 3, 93 - 98, 27.09.2023

Ece Uysal

https://doi.org/10.46810/tdfd.1341318

Abstract

Introduction
Patients with a lumbar catheter become prone to infection due to the outflow of CSF. This research aimed to investigate how tunneled lumbar drainage affected infection in patients undergoing lumbar drainage.
Materials and Methods
This study was conducted on patients with lumbar drainage who were hospitalized for various clinical reasons. Subcutaneous drain length was measured by post-procedural lumbar tomography. The length of the lumbar drainage catheter, the duration of lumbar drainage, fever monitoring, CSF leakage, biochemical blood tests, the length of hospitalization, infection were recorded.
Results
This study comprised a total of 93 cases with external lumbar drainage. 51 (54.8%) of the 93 cases were inserted using the classic technique, 42 (45.2%) were inserted using the tunneled technique. The rate of CSF leakage was decreased using the tunneling approach (p = 0.003). A significant correlation was established between CSF leakage around the drain and subcutaneous drain length. CSF culture was negative in 78.8% of patients with subcutaneous drain lengths between 0 cm and 3 cm, and 100% of patients with subcutaneous drain lengths of 5 cm or more. Seven days or less was the cutoff value for negative CSF culture.
Conclusion
External lumbar draining can lead to issues such as infection and CSF leakage. The tunneling procedure is straight forward, affordable, and successfully prevents these complications.

Keywords

Lumbar puncture, Cerebrospinal Fluid Leak, Meningitis

SUBKUTAN TÜNELLEMENİN EKSTERNAL LOMBER DRENAJ KOMPLİKASYONLARINA ETKİSİ

Abstract

Giriş
Bel bölgesinde uzun süre kateter bulunan hastalar, BOS sıvısının dış ortama çıkışı nedeniyle enfeksiyona yatkın hale gelebilir. Bu araştırma, tünelli lomber drenajın lomber drenaj uygulanan hastalarda enfeksiyonu nasıl etkilediğini araştırmayı amaçladı.
Gereç ve Yöntem
Bu çalışma, çeşitli klinik nedenlerle hastaneye yatırılan lomber drenajlı hastalar üzerinde yapılmıştır. Subkutan dren uzunluğu işlem sonrası lomber tomografi ile ölçüldü. Lomber drenaj kateterinin uzunluğu, lomber drenaj süresi, ardından ateş izlemi, lomber drenaj çevresinden BOS sızıntısı ve günlük biyokimyasal kan testleri, hastanede kalış süresi, enfeksiyon ve antibiyotik ihtiyacı kaydedildi.
Bulgular
Bu çalışma eksternal lomber drenajı olan toplam 93 olguyu içermektedir. Doksan üç olgunun 51'i (%54.8) klasik teknikle, 42'si (%45.2) ise tünelli teknikle yerleştirildi. BOS kaçağı oranı, tünelleme yaklaşımı kullanılarak azaltıldı (p = 0.003). Hastanede kalış süresi açısından iki işlem arasında fark yoktu. Dren etrafındaki BOS sızıntısı ile subkutan dren uzunluğu arasında istatistiksel olarak anlamlı bir ilişki saptandı. Subkutan dren uzunluğu 0-3 cm arasında olan hastaların %78.8'inde, 5 cm ve üzeri dren uzunluğu olan hastaların ise %100'ünde BOS kültürü negatifti. Negatif BOS kültürü için cut-0ff değeri yedi gün olarak belirlendi.
Tartışma ve Sonuç
Dış lomber drenaj, enfeksiyon ve BOS sızıntısı gibi sorunlara yol açabilir. Tünel açma prosedürü basittir, ekonomiktir ve bu komplikasyonları başarılı bir şekilde önler.

Keywords

Lomber ponksiyon, Beyin omurilik sıvısı, Menenjit

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