Management of exposed ventriculoperitoneal shunt on the scalp in pediatric patients

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Plastic Surgery

Background:

• Ventriculoperitoneal shunt exposure on the scalp is a significant complication in pediatric neurosurgery.
• Limited literature exists on effective management strategies for this condition.

Purpose of the Study:

• To define management protocols for ventriculoperitoneal shunt salvage.
• To outline methods for scalp reconstruction following shunt exposure.

Main Methods:

• Retrospective study of seven pediatric patients with exposed ventriculoperitoneal shunts.
• Analysis of demographic data, medical/surgical treatments, and follow-up outcomes.
• Evaluation of complications associated with various management techniques.

Main Results:

• Seven pediatric patients (4 female, 3 male; average age 5.7 years) were followed for an average of 9.4 months.
• Shunt salvage was achieved in all but one patient, avoiding shunt removal.
• Successful scalp reconstruction was performed using single (1 patient) or double (5 patients) skin flaps.
• No complications were observed during the follow-up period for the treated patients.

Conclusions:

• Effective scalp reconstruction is achievable without necessitating ventriculoperitoneal shunt removal.
• Appropriate infection prevention is crucial for successful shunt salvage and scalp repair.
• This study highlights a practical management approach for pediatric shunt exposure cases.