Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Closure of Myelomeningocele Within 48 Hours to Decrease Infection Risk

被引:6
作者
Beier, Alexandra D. [1 ]
Nikas, Dimitrios C. [2 ]
Assassi, Nadege [3 ]
Bauer, David F. [4 ]
Blount, Jeffrey P. [5 ]
Durham, Susan R. [6 ]
Flannery, Ann Marie [7 ]
Klimo, Paul, Jr. [8 ,9 ,10 ]
McClung-Smith, Catherine [11 ]
Rehring, Patricia [12 ]
Tamber, Mandeep S. [13 ]
Tyagi, Rachana [14 ]
Mazzola, Catherine A. [15 ,16 ]
机构
[1] Univ Florida Hlth Jacksonville, Div Pediat Neurosurg, Jacksonville, FL USA
[2] Advocate Childrens Hosp, Div Pediat Neurosurg, Oak Lawn, IL USA
[3] Univ Med & Dent New Jersey, Dept Surg, Div Neurosurg, New Brunswick, NJ USA
[4] Dartmouth Hitchcock Med Ctr, Dept Surg, Div Neurosurg, Lebanon, NH 03766 USA
[5] Univ Alabama Birmingham, Dept Neurosurg, Div Pediat Neurosurg, Childrens Alabama, Birmingham, AL USA
[6] Univ Vermont, Med Ctr, Burlington, VT USA
[7] Womens & Childrens Hosp, Kids Specialty Ctr, Lafayette, LA USA
[8] Semmes Murphey, Memphis, TN USA
[9] Univ Tennessee, Ctr Hlth Sci, Dept Neurosurg, Memphis, TN 38163 USA
[10] Le Bonheur Childrens Hosp, Memphis, TN USA
[11] Palmetto Hlth USC Med Grp, Dept Neurol Surg, Columbia, SC USA
[12] Congress Neurol Surg, Schaumburg, IL USA
[13] Univ British Columbia, British Columbia Childrens Hosp, Div Pediat Neurosurg, Vancouver, BC, Canada
[14] Mercer Univ, Sch Med, Dept Neurosurg, Macon, GA 31207 USA
[15] Goryeb Childrens Hosp, Morristown, NJ USA
[16] Rutgers Dept Neurol Surg, Newark, NJ USA
关键词
Fetal; Infection; Meningitis; Myelomeningocele; Surgery; Ventriculitis; TIME;
D O I
10.1093/neuros/nyz264
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
BACKGROUND 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. OBJECTIVE The objective of this guideline is to determine if closing the MM within 48 h decreases the risk of wound infection or ventriculitis. METHODS 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. RESULTS 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. CONCLUSION 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. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-4.
引用
收藏
页码:E412 / E413
页数:2
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