Cranioplasty Outcomes and Analysis of the Factors Influencing Surgical Site Infection: A Retrospective Review of More than 10 Years of Institutional Experience.
BACKGROUND
As a large amount of clinical evidence supports the use of craniectomy, the frequency of subsequent cranioplasty is increasing. Conflicting complication rates and risk factors of cranioplasty have been reported. We reviewed >10 years of institutional experience to identify risk factors of surgical site infection (SSI) after cranioplasty.


METHODS
A retrospective review was conducted of patients who underwent primary cranioplasty. Patients <16 years old, patients with a history of cranial infection, and patients who underwent ventricular shunt surgery were excluded. There were 155 patients eligible for analysis. 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 98 minutes, and the relative risk ratio was 7.4 in patients with an operative time of >98 minutes.


CONCLUSIONS
A high number of complications can occur after cranioplasty. Close attention should be paid to SSI development in patients who require a long operative time.
Department of Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. Electronic address: kshibahashi@yahoo.co.jp.
Keita
K
Shibahashi
Department of Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Hidenori
H
Hoda
Department of Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Yuichi
Y
Takasu
Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Kazuo
K
Hanakawa
Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Takafumi
T
Ide
Department of Emergency and Intensive Care Center, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
Yuichi
Y
Hamabe
D000328:Adult; D000368:Aged; D056424:Decompressive Craniectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects*; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D015898:Tomography Scanners, X-Ray Computed
Complications; Craniectomy; Cranioplasty; Risk factors; Surgical site infection