{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:02:22Z","timestamp":1790704942049,"version":"4.1.0"},"reference-count":4,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T00:00:00Z","timestamp":1565913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Appropriate timing for closure of myelomeningocele (MM) varies in the literature. Older studies present 48 h as the timeframe after which infection complication rates rise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective of this guideline is to determine if closing the MM within 48 h decreases the risk of wound infection or ventriculitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for relevant literature published between 1966 and September 2016. Strict inclusion\/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-text review. Full text articles were then reviewed and when appropriate, included in the evidentiary table. The class of evidence was evaluated, discussed, and assigned to each study that met inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 148 abstracts were identified and reviewed. A total of 31 articles were selected for full text analysis. Only 4 of these studies met inclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>There is insufficient evidence that operating within 48 h decreases risk of wound infection or ventriculitis in 1 Class III study. There is 1 Class III study that provides evidence of global increase in postoperative infection after 48 h, but is not specific to wound infection or ventriculitis. There is 1 Class III study that provides evidence if surgery is going to be delayed greater than 48 h, antibiotics should be given.<\/jats:p>\n                    <jats:p>The full guideline can be found at https:\/\/www.cns.org\/guidelines\/guidelines-spina-bifida-chapter-4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyz264","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T15:14:16Z","timestamp":1565622856000},"page":"E412-E413","source":"Crossref","is-referenced-by-count":14,"title":["Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Closure of Myelomeningocele Within 48 Hours to Decrease Infection Risk"],"prefix":"10.1227","volume":"85","author":[{"given":"Alexandra D","family":"Beier","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, University of Florida Health Jacksonville, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios C","family":"Nikas","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Advocate Children's Hospital, Oak Lawn, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadege","family":"Assassi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Robert Wood Johnson Medical School, New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey P","family":"Blount","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, University of Alabama at Birmingham; Children's of Alabama, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R","family":"Durham","sequence":"additional","affiliation":[{"name":"The University of Vermont Medical Center, Burlington, Vermont"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann Marie","family":"Flannery","sequence":"additional","affiliation":[{"name":"Kids Specialty Center, Women's & Children's Hospital, Lafayette, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Klimo","sequence":"additional","affiliation":[{"name":"Semmes-Murphey, Memphis, Tennessee"},{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"},{"name":"Le Bonheur Children's Hospital, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"McClung-Smith","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Palmetto Health USC Medical Group, Columbia, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-2981","authenticated-orcid":false,"given":"Patricia","family":"Rehring","sequence":"additional","affiliation":[{"name":"Congress of Neurological Surgeons, Schaumburg, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandeep S","family":"Tamber","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachana","family":"Tyagi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mercer University Medical School, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine A","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Goryeb Children's Hospital, Morristown, NJ; Rutgers Department of Neurological Surgery, Newark, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,9]]},"reference":[{"issue":"3","key":"bib1-20231011","first-page":"287","article-title":"Ventriculitis in newborns with myelomeningocele","volume":"145","author":"Charney","year":"1991","journal-title":"Am J Dis Child"},{"issue":"Suppl. II","key":"bib2-20231011","first-page":"90","article-title":"Myelomeningocele newborn management: time for parental decision","volume":"38","author":"Charney","year":"1983","journal-title":"Z Kinderchir"},{"issue":"2","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000209285","article-title":"Surgical treatment of myelomeningocele carried out at \u2018time zero\u2019 immediately after birth","volume":"45","author":"Pinto","year":"2009","journal-title":"Pediatr Neurosurg"},{"issue":"9","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1007\/s00381-016-3165-4","article-title":"Infection rate correlated with time to repair of open neural tube defects (myelomeningoceles): an institutional and national study","volume":"32","author":"Attenello","year":"2016","journal-title":"Childs Nerv Syst"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyz264","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:05Z","timestamp":1786121405000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyz264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,16]]},"references-count":4,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyz264","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,16]]}}}