The Simple Urine Bag as Wound Drain Post-Craniotomy in a Low-resource Neurosurgical Practice: A Personal 4-year Prospective Cohort Study

Abstract

Background: In the face of the practical non-availability of custom-made surgical wound drain materials, many other substitutes are used in  developing countries. These substitutes have their draw backs from which the Uribag appears to be free. The main objectives: To present our experience with the use of this cheap and readily-available material as post craniotomy wound drain in a Nigerian neurosurgical unit

Methods: A 4-year prospective cohort study of the effectiveness, outcome with use and complications of the Uribag as post craniotomy wound drain in a consecutive cohort of neurosurgical patients. Data analyzed include the patients’ brief demographics; the types of cranial surgery in which drain was used; the drain performance, and any associated untoward drain /
wound events.

Results: The drain was used for this purpose in 107 patients over 4 years. Nineteen have been excluded from this analysis because they died too soon post op for drain performance to be measured. The 88 patients analyzed included 60 males (68%); age range 11 days to 75 years.
Cranial surgery was for trauma in 42% and for brain tumour resection and other cranial procedures in the rest. The drain output ranged from 40mls to 960mls and was in place for an average of 3 days. There was 1 episode (1.1%) of drain dislodgement; 3 of drain blockage (3.4%) and 5 cases (5.7%) of wound complication post drain removal. All wounds healed with primary intention otherwise.
Conclusions: The Uribag is an effective, very cheap, and complication-free, closed tube wound drain substitute for cranial surgery.

Keywords: postsurgical wound drain substitute, developing country, craniotomy, neurosurgery, Uribag