What is the Chou Procedure?

A procedure used in neurosurgery in an attempt to save a cranioplasty flap after an infection. Paper by Dr. Chou in 1974 describes the procedure.


Open debridement. Placement of two channel drains (or 4). Placed superior and inferior in the subgaleal (or subgaleal and epidural).


Paper originally used 1 g of Keflin (cefalotin).  Irrigating solution is infused at a rate of 1-2 liters per 24 hours (40-80 mL/hr)  and continued for 5 days.


Nursing note: call if output is 10 mL or more different than input.



Erickson, Seljeskog, and Chou. Suction-irrigation treatment of craniotomy infections. J neurosurgery. 1974 Aug; 41(2):265-7