title: There are No Differences between Factors Determining Graft Infection in Autologous Bone Flap Replacement and Acrylic Cranioplasty: A Prospective Observational Study at Hospital Kuala Lumpur.
abstract: OBJECTIVE
  This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL).
  
  
  METHODS
  This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventy-two patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38.2%) were acrylic cranioplasty.
  
  
  RESULTS
  A total of five infected grafts were identified among the 172 cases included in the study, resulting in an overall infection rate of 2.9%. Of this infected group, three (4.5%) were cases of cranioplasty and two (1.9%) were cases of autologous bone flap replacement. There was high proportion of male patients undergoing cranioplasty (118 [or 68.6%]) and only 54 (or 31.4%) female patients. The primary pathology in the majority of patients (126 [or 73.2%]) was due to trauma; only 46 cases (or 26.8%) did not result from trauma. Of the patients, 123 (or 71.5%) had undergone a single cranial procedure prior to their cranioplasty, and 43 (or 28.5%) had undergone multiple cranial procedures. Most of the patients (114 [or 66.3%]) underwent cranioplasty 90 days after undergoing decompressive craniectomy while 58 (or 33.7%) underwent cranioplasty less than 90 days after decompressive craniectomy.
authors.affiliation: Institut Kajisaraf Tunku Abdul Rahman (IKTAR), Hospital Kuala Lumpur, 50586 Jalan Pahang, Kuala Lumpur, Malaysia; Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia; Department of Neurosciences, Hospital Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
authors.forename: Siti Azleen
authors.initials: SA
authors.lastname: Mohamad
authors.affiliation: Institut Kajisaraf Tunku Abdul Rahman (IKTAR), Hospital Kuala Lumpur, 50586 Jalan Pahang, Kuala Lumpur, Malaysia; Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia; Department of Neurosciences, Hospital Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
authors.forename: Mohd Safari
authors.initials: MS
authors.lastname: Mohd Haspani
authors.affiliation: Department of Neurosciences, School of Medical Sciences, Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia; Department of Neurosciences, Hospital Universiti Sains Malaysia, Jalan Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kota Bharu, Kelantan, Malaysia.
authors.forename: Badrisyah
authors.initials: B
authors.lastname: Idris
keywords: cranium; graft; infection; neuroscience