Reduction of external ventricular drain associated infections after introduction of a chlorhexidine containing dressing
EANS Academy. Röthlisberger M. 09/27/19; 275995; EP12057
Dr. Michel Röthlisberger
Dr. Michel Röthlisberger

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy

Discussion Forum (0)
Rate & Comment (0)
Background: Dressings containing chlorhexidine (CHX) lower the incidence of external ventricular drain (EVD)-associated infections (EVDAIs). In a previous prospective randomized trial (RCT) at the University Hospital Basel (NCT02078830), a significant reduction in bacterial cutaneous and catheter colonization was detected. However, the study was underpowered to demonstrate an effect on the incidence of EVDAI.
Methods: Retrospective (2009-2013) and prospective (2014-2017) review of patients undergoing EVD-insertion at the University Hospital Basel. The control group consisted of patients from January 2009 to October 2013, where the CHX-dressings were not in use. The study group consisted of patients between February 2016 and December 2017, where CHX-dressing was standard of care. Comparisons were made using the Chi-squared test. Primary endpoint was the diagnosis of EVDAI. Statistical significance was set at P ≤ .05.
Results: 224 out of 306 (73.2%) patients were eligible for analysis. 79 out of 224 (35.3%) were assigned to the control group, 55 out of 224 (24.6%) to the RCT-group and 90 out of 224 (40.2%) to the study group. During the whole study period, 118 out of 224 (52.7%) received a CHX-dressing while 106 out of 224 (47.3%) did not. The rate of EVDAI were substantially lower after the introduction of the CHX-dressing but did not reach significance (p=.083). However, 11 out of 118 (9.3%) in the CHX- compared to 20 out of 106 (18.9%) in the Non-CHX-group developed EVDAI (p=.039).

  Before introduction of CHX-dressing EVDAI-RCT (NCT02078830) After introduction of CHX-dressing Total
Time Period Jan 2009 to Oct 2013 Oct 2013 to Jan 2016 Feb 2016 and Dec 2017  
EVDAI 13 (16.4%) 11 (20%) 7 (7.8%) 31 (13.8%)
No EVDAI 66 (83.6%) 44 (80%) 83 (92.2%) 193 (86.2%)
Total 79 (100%) 55 (100%) 90 (100%) 224 (100%)
[Table 1: Infection rates before, during and after the introduction of CHX-containing dressings as a standard of care for the exit site of EVD]

Conclusion: CHX-containing dressings as a standard of care for the exit site of EVD effectively reduce the incidence of EVDAI.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings