title: Is cranial reconstruction with a hard-tissue replacement patient-matched implant as safe as previously reported? A 3-year experience and review of the literature.
abstract: OBJECTIVE
  This study aimed to verify the low complication rates (0% to 11%) previously reported in cranial reconstruction using hard-tissue replacement patient-matched implant (HTR-PMI).
  
  
  METHODS
  A 3-year multidisciplinary experience involving 21 patients undergoing HTR-PMI reconstruction of large cranial defects was reviewed. Complications were defined as implant exposure, implant infection, or soft-tissue infection.
  
  
  RESULTS
  A statistically higher rate of complications was observed, compared with previous series (P= .043). We also determined whether previous bone infection, a history of diabetes, or smoking were risk factors for the development of complications. Diabetes, smoking, and pre-existing bone/implant infections were not significant risk factors for HTR-PMI failure. The higher rate of complications can be partially attributed to a diverse and complicated patient population, with multiple comorbid conditions and various indications for HTR-PMI reconstruction. In particular, decompressive craniectomies in trauma patients can be risky indications for the use of HTR-PMI.
  
  
  CONCLUSIONS
  Larger studies are suggested to verify our findings.
authors.affiliation: Neuroscience Graduate Program, Oregon Health and Science University School of Medicine, Portland, OR 97239, USA.
authors.forename: Naiem
authors.initials: N
authors.lastname: Nassiri
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Cleary
authors.forename: Brett A
authors.initials: BA
authors.lastname: Ueeck
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000601:surgery; D002675:Child, Preschool; D003399:Craniotomy / Q000009:adverse effects*; D020878:Device Removal; D004869:Equipment Safety; D005260:Female; D020197:Head Injuries, Penetrating / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers; D019736:Prostheses and Implants / Q000009:adverse effects*; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence; D013530:Surgical Wound Infection; D055815:Young Adult
chemical_list: D011108:Polymers