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Rivista di Chirurgia
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 October;27(5):269-72
A retrospective review of infections after cranioplasty over a decade at a single center
Jang H. J. 1, Oh C. H. 2, Shim Y. S. 1, Yoon S. H. 1, Hyun D. 1, Park H. 1, Kim E. 1, Yeul Ji G. 3
1 Department of Neurosurgery, Inha University College of Medicine, Incheon, South Korea;
2 Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, South Korea;
3 Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
AIM: Postoperative infections, including surgical site infections (SSI) and bone graft infections after cranioplasty (BIC), are of major concern when performing a cranioplasty. This study reviewed infection rates after cranioplasty and identified factors related to postoperative infection after cranioplasty via a retrospective review of data collected over a decade at single center.
METHODS: Between 2002 and 2012, at a single university hospital, a total of 92 patients underwent reconstructive cranioplasty after decompressive craniectomy. Autografts were used for cranioplasty when available and polymethylmethacrylate (PMMA) was considered when autografts were not available. Infections after cranioplasty were confirmed by clinical signs, laboratory test, and imaging studies, and related factors were evaluated retrospectively.
RESULTS: Infections after cranioplasty occurred in 15 patients (16.3%). There were 7 cases (7.6%) of SSI and 8 cases (8.7%) of BIC. Infection rates were not different according to sex, age, operation year, surgeons, operation time, and operation interval from the time of decompressive craniectomy to cranioplasty. The only significant difference was observed between cranioplasty material: PMMA showed a higher rate of infection than autologous bone. The most common pathogen causing SSI and BIC was methicillin-resistant Staphylococcus aureus (MRSA) (11 cases, 73.3%); other minor pathogens included vancomycin-resistant Enterococcus (VRE) and Corynebacterium, with 1 case each.
CONCLUSION: Postoperative infection after cranioplasty developed in 16.3% of patients, mainly from MRSA, in our single center retrograde review. The key risk factor of infection rate was cranioplasty material, and no other factor was conclusively shown to have an effect on infection rates.