Cranioplasty outcomes and analysis of the factors influencing surgical-site infection: a retrospective review of over 10 years of institutional experience

• Published in: World neurosurgery 2017
• Main Authors: Shibahashi, Keita, Hoda, Hidenori, Takasu, Yuichi, Hanakawa, Kazuo, Ide, Takafumi, Hamabe, Yuichi
• Format: Article
• Language: English
• Subjects: Neurosurgery
• ISSN: 1878-8750
• DOI: 10.1016/j.wneu.2017.01.106

Abstract Background As a large amount of clinical evidence supports the effects of craniectomy, the frequency of subsequent cranioplasty is on the rise. Complication rates and risk factors of cranioplasty have been reported; however, they have been conflicting. We aimed to review over 10 years of institutional experience and identify the risk factors of surgical-site infection (SSI) after cranioplasty. Methods A retrospective review was conducted for patients who underwent primary cranioplasty. Patients younger than 16 years, who had a history of cranial infection and those who underwent ventricular shunt surgery were excluded. A total of 155 patients were eligible for analysis. Complete review was performed to investigate the complication rate, and the risk factors associated with SSI were determined. Results The overall complication rate was 12.3%. There were 13 cases of SSI (8.4%), 4 cases of postoperative epidural hemorrhage (2.6%), and 2 cases of postoperative wound dehiscence (1.3%). There was a significant relationship between operative time and SSI ( P < 0.001). The optimal cutoff value of operative time for predicting SSI was found to be 98 min, and the relative risk ratio was 7.4 in patients with an operative time of over 98 min. Conclusion A high number of complications can occur following cranioplasty. Close attention should be paid to SSI development in patients who require a long operative time.