{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:09:35Z","timestamp":1790644175018,"version":"4.1.0"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":2302,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>\n          Background: External ventricular drains (EVD) are commonly utilized for temporary diversion of cerebrospinal fluid (CSF). Many neurosurgeons prefer long-tunneled EVDs in their routine practice. However, it is still unclear whether this extended tunneling helps in reducing CSF infection. Keeping this in mind, we decided to compare infection rates in long-tunneled versus short-tunneled EVDs in the setting of a developing country. Materials and Methods: A prospective study of 60 patients was conducted. Consenting patients who underwent short-tunneled (Group A) or long-tunneled (Group B) EVDs between January 2008 and June 2009 were followed during the course of their inpatient care. All operational protocol was standardized during the trial. Serial samples of CSF were analyzed to detect infection. Results: Mean age of patients was 33.6 years with 32 males (53.3%). Mean duration of long-tunneled EVD was 13.4 \u00b1 7.2 days, whereas that of short-tunneled EVD was 5.3 \u00b1 2.7 days (P &lt; 0.001). Three patients with long-tunneled EVD (10.0%), whereas one patient with short-tunneled EVD (3.3%) developed drain-related infections; however, this was non-significant (P = 0.301). However, patients with short-tunneled EVD got infected earlier on day 3when compared with the long-tunneled EVDs, which got infected after a mean duration of 7.3 days. The overall risk of infection for long-tunneled EVDs was 7.46 per 1,000 ventricular drainage days which was comparable to the risk of 6.33 per 1,000 ventricular drainage days seen for short-tunneled EVDs. Conclusion: Long-tunneled EVDs appear to only delay potential infections without having any effect on the actual risk of infection. Long-tunneled EVD in a resource-limited setting is technically challenging and may not yield additional benefits to the patient. However, larger and prospective studies are needed to establish the rate of infections and other complications.<\/jats:p>","DOI":"10.4103\/1793-5482.145052","type":"journal-article","created":{"date-parts":[[2014,11,19]],"date-time":"2014-11-19T12:15:42Z","timestamp":1416399342000},"page":"114-117","source":"Crossref","is-referenced-by-count":16,"title":["Long-tunneled versus short-tunneled external ventricular drainage: Prospective experience from a developing country"],"prefix":"10.1055","volume":"11","author":[{"given":"Muhammad","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neurosurgery, Alder Hey Children's NHS Trust, Liverpool"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zain","family":"Sobani","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed","family":"Murtaza","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed","family":"Enam","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"key-10.4103\/1793-5482.145052-1","first-page":"359","volume-title":"Extended subcutaneous tunnelling technique for external ventricular drainage","author":"Leung","year":"2007","journal-title":"Br J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-2","first-page":"333","volume-title":"Role of cerebrospinal fluid diversion in posterior fossa tumor surgery","author":"Ghani","year":"2003","journal-title":"J Coll Physicians Surg Pak"},{"key":"key-10.4103\/1793-5482.145052-3","first-page":"1465","volume-title":"Prophylactic antibiotics in pediatric shunt surgery","author":"Biyani","year":"2006","journal-title":"Childs Nerv Syst"},{"key":"key-10.4103\/1793-5482.145052-4","first-page":"209","volume-title":"Risk factors for infections related to external ventricular drainage","author":"Hoefnagel","year":"2008","journal-title":"Acta Neurochir (Wien)"},{"key":"key-10.4103\/1793-5482.145052-5","first-page":"241","volume-title":"Placement of external ventricular drains and intracranial pressure monitors by neurointensivists","author":"Ehtisham","year":"2009","journal-title":"Neurocrit Care"},{"key":"key-10.4103\/1793-5482.145052-6","first-page":"79","volume-title":"Relative risks of ventriculostomy infection and morbidity","author":"Paramore","year":"1994","journal-title":"Acta Neurochir (Wien)"},{"key":"key-10.4103\/1793-5482.145052-7","first-page":"381","volume-title":"Infection related to intracranial pressure monitors in adults: Analysis of risk factors and antibiotic prophylaxis","author":"Rebuck","year":"2000","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"key-10.4103\/1793-5482.145052-8","first-page":"1064","volume-title":"Antibiotics-impregnated ventricular catheter versus systemic antibiotics for prevention of nosocomial CSF and non-CSF infections: A prospective randomised clinical trial","author":"Wong","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"key-10.4103\/1793-5482.145052-9","first-page":"48","volume-title":"The risk factors of external ventricular drainage-related infection at hospital kualalumpur: An observational study","author":"Omar","year":"2010","journal-title":"Malays J Med Sci"},{"key":"key-10.4103\/1793-5482.145052-10","first-page":"791","volume-title":"Prolonged external ventricular drainage with percutaneous long-tunnel ventriculostomies","author":"Khanna","year":"1995","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-11","first-page":"450","volume-title":"A simplified apparatus for constant ventricular drainage","author":"Bering","year":"1951","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-12","first-page":"465","volume-title":"Intraventricularhaematoma: Management of comatose patients with valve regulated external ventricular drainage","author":"Chan","year":"1988","journal-title":"Br J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-13","first-page":"146","volume-title":"CSF antibiotic prophylaxis for neurosurgical patients with ventriculostomy: A randomised study","author":"Poon","year":"1998","journal-title":"Acta Neurochir Suppl"},{"key":"key-10.4103\/1793-5482.145052-14","first-page":"553","volume-title":"Ventriculostomy-related infections.A prospective epidemiologic study","author":"Mayhall","year":"1984","journal-title":"N Engl J Med"},{"key":"key-10.4103\/1793-5482.145052-15","first-page":"1064","volume-title":"Antibiotics-impregnated ventricular catheter versus systemic antibiotics for prevention of nosocomial CSF and non-CSF infections: A prospective randomised clinical trial","author":"Wong","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"key-10.4103\/1793-5482.145052-16","first-page":"296","volume-title":"External ventricular drain infection: The effect of a strict protocol on infection rates and a review of the literature","author":"Dasic","year":"2006","journal-title":"Br J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-17","first-page":"1021","volume-title":"Hemorrhage rates after external ventricular drain placement","author":"Gardner","year":"2009","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-18","first-page":"229","volume-title":"Bacterial meningitis caused by the use of ventricular or lumbar cerebrospinal fluid catheters","author":"Schade","year":"2005","journal-title":"J Neurosurg"},{"key":"key-10.4103\/1793-5482.145052-19","first-page":"419","volume-title":"Ventriculostomy infections: The effect of monitoring duration and catheter exchange in 584 patients","author":"Holloway","year":"1996","journal-title":"J Neurosurg"}],"container-title":["Asian Journal of 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