caa a22 4500 606216464 CHVBK 20210128101103.0 cr unu---uuuuu 210128e20150201xx s 000 0 eng 10.1007/s00701-014-2296-1 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2296-1 Prospective comparison of simple suturing and elevation debridement in compound depressed fractures with no significant mass effect [Elektronische Daten] [Kanchan Mukherjee, Sivashanmugam Dhandapani, Alok Sarda, Manjul Tripathi, Pravin Salunke, Anand Srinivasan, Manoj Tewari, Suresh Mathuriya] Background: Compound depressed fractures have conventionally been managed surgically with elevation and debridement to avoid infection, especially when there is dural penetration, nonetheless with little evidence. This study was to prospectively compare outcomes after simple suturing and elevation debridement in patients with compound depressed fractures. Methods: Patients of compound depressed fracture with GCS of five or more, no serious systemic injury, and no significant mass effect were prospectively studied for various factors in relation to infection, hospital stay, survival, and late post-traumatic seizures. Univariate and multivariate analyses were performed using SPSS21. Results: Of the total 232 patients with complete clinico-radiological and follow-up data, 183 underwent simple cleansing and suturing, and 49 underwent surgical elevation debridement. The surgical group at baseline had significantly lower GCS, greater dural violation, and brain matter herniation compared to the conservative arm. Univariate analysis showed simple suturing group to have significantly shorter hospital stay (2.4 vs. 10.3days) (p < 0.001), lesser infection among survivors (4 vs. 21%) (p = 0.001), and greater ‘survival with no infection' (85 vs. 69%) (p = 0.01). Multivariate analysis adjusting for age, sex, GCS, dural penetration, and surgical intervention confirmed significantly shorter hospital stay (p < 0.001) and lesser infection among survivors (p = 0.02) in the simple suturing group. Overall, there was no benefit offered by surgical debridement. Simple suturing had a better outcome in most subgroups, except in those with brain matter herniation and GCS 5-8, which showed non-significant benefit with surgical intervention. Conclusions: Simple suturing seems to be an equally good option in patients with compound depressed fracture with no significant mass effect or brain matter herniation. Springer-Verlag Wien, 2014 Compound depressed fracture nationallicence Simple suturing nationallicence Elevation debridement nationallicence Infection nationallicence Outcome nationallicence Survival nationallicence Seizure nationallicence Hospital stay nationallicence Mukherjee Kanchan Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Dhandapani Sivashanmugam Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Sarda Alok Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Tripathi Manjul Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Salunke Pravin Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Srinivasan Anand Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Tewari Manoj Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Mathuriya Suresh Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 305-309 0001-6268 157:2<305 2015 157 701 https://doi.org/10.1007/s00701-014-2296-1 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2296-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mukherjee Kanchan Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Dhandapani Sivashanmugam Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Sarda Alok Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Tripathi Manjul Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Salunke Pravin Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Srinivasan Anand Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Tewari Manoj Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 700 1- Mathuriya Suresh Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), 160012, Chandigarh, India aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/2(2015-02-01), 305-309 0001-6268 157:2<305 2015 157 701