Combined early myelomeningocele repair and antibiotic-impregnated ventriculoperitoneal shunt insertion in treatment of Chiari 2 malformation with overt hydrocephalus: Outcome of 25 consecutive cases

Document Type : Original Articles

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1 Tanta University Faculty of Medicine

2 Plastic surgery department ,Tanta University,Egypt

Abstract

Abstract
Background: Shunt infection represents a serious complication in patients undergoing repair of myelomeningocele (MMC) with overt hydrocephalus.
Objective: This study aimed to assess the infection rate in patients who underwent combined early MMC repair with placement of antibiotic-impregnated shunt at the same setting.
Methods: This study was carried out on live birth neonates with MMC and overt hydrocephalus who were admitted to Tanta University Hospitals during March 2014 throughout October 2019. All patients underwent simultaneous repair of MMC and placement of antibiotic-impregnated shunt within 48 hours after birth. Patients were followed up for six months postoperatively.
Results: Twenty-five patients were included. Evan’s index significantly decreased after surgery (0.340.03 vs. 0.290.02, respectively; p < 0.001). Postoperative complications included partial wound dehiscence (12%) and infection (8%).
Conclusion: Antibiotic-impregnated shunts have a potential prophylactic role in the management of neonates with MMC and overt hydrocephalus. However, clinical trials with larger sample size and a control arm with standard shunts should be conducted to elucidate this effect.

Keywords: hydrocephalus; infection ;myelomeningocele; ventriculoperitoneal shunt .

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