title: Acute autologous bone flap infection after cranioplasty for postinjury decompressive craniectomy.
abstract: BACKGROUND
  Acute bone flap infection is a devastating complication after cranioplasty for postinjury decompressive craniectomy. We aim to identify the risk factors of autologous bone flap infection.
  
  
  METHODS
  We enrolled 151 patients undergoing 153 cranioplasties in the 4-year retrospective study. Autologous bones stored at -75°C were used in the cranioplasties. Acute bone flap infection was defined as the onset of infection ≤14 days after cranioplasty. The epidemiological data of patients and details of the cranioplasty procedure were recorded.
  
  
  RESULTS
  Acute bone flap infection was identified in five of the 153 cranioplasties, accounting for 3.3% of all episodes. Three of the 5 infected patients and five of 143 uninfected patients presented with dysfunction of subgaleal drainage comparatively, which was significantly different (p=0.001). Statistical analysis of the cranioplasty procedures and subsequent results of the two patient groups revealed the following significant findings: the duration of operation (p=0.03) and the length of hospital stay after cranioplasty (p<0.001).
  
  
  CONCLUSIONS
  Dysfunction of subgaleal drainage and long operative duration of cranioplasty are risk factors of acute autologous bone flap infection. Regarding the prolonged hospital stay in complicated patients, better surgical techniques should be implemented in order to eliminate the risks of infection.
authors.affiliation: Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Huang
authors.forename: Tzu-Ming
authors.initials: TM
authors.lastname: Yang
authors.forename: Tao-Chen
authors.initials: TC
authors.lastname: Lee
authors.forename: Wu-Fu
authors.initials: WF
authors.lastname: Chen
authors.forename: Ka-Yen
authors.initials: KY
authors.lastname: Yang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000009:adverse effects* / Q000379:methods; D003399:Craniotomy / Q000009:adverse effects* / Q000379:methods; D056424:Decompressive Craniectomy / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome