Early cranioplasty vs. late cranioplasty for the treatment of cranial defect: A systematic review

Xu, Huibi; Niu, Chaoshi; Fu, Xianming; Ding, Weijun; Ling, Shiying; Jiang, Xiaofeng; Ji, Ying

doi:10.1016/j.clineuro.2015.05.031

Cited by 88 publications

(81 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Intracranial infection directly affects the prognosis of patients with high mortality and morbidity rate (3 –5). Earlier reports indicate a 2.6 and 0.5% prevalence of intracranial infection after craniotomy in China (6), and USA, respectively (7). Timely diagnosis of intracranial infection after craniotomy is the key to improve the prognosis of patients.…”

Section: Introductionmentioning

confidence: 93%

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

2017

Braz J Med Biol Res

View full text Add to dashboard Cite

Intracranial infection is a common clinical complication after craniotomy. We aimed to explore the diagnostic and prognostic value of dynamic changing procalcitonin (PCT) in early intracranial infection after craniotomy. A prospective study was performed on 93 patients suspected of intracranial infection after craniotomy. Routine peripheral venous blood was collected on the day of admission, and C reactive protein (CRP) and PCT levels were measured. Cerebrospinal fluid (CSF) was collected for routine biochemical, PCT and culture assessment. Serum and CSF analysis continued on days 1, 2, 3, 5, 7, 9, and 11. The patients were divided into intracranial infection group and non-intracranial infection group; intracranial infection group was further divided into infection controlled group and infection uncontrolled group. Thirty-five patients were confirmed with intracranial infection after craniotomy according to the diagnostic criteria. The serum and cerebrospinal fluid PCT levels in the infected group were significantly higher than the non-infected group on day 1 (P<0.05, P<0.01). The area under curve of receiver operating characteristics was 0.803 for CSF PCT in diagnosing intracranial infection. The diagnostic sensitivity and specificity of CSF PCT was superior to other indicators. The serum and CSF PCT levels have potential value in the early diagnosis of intracranial infection after craniotomy. Since CSF PCT levels have higher sensitivity and specificity, dynamic changes in this parameter could be used for early detection of intracranial infection after craniotomy, combined with other biochemical indicators.

show abstract

Section: Introductionmentioning

confidence: 93%

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

2017

Braz J Med Biol Res

View full text Add to dashboard Cite

show abstract

“…38 Therefore, an important concern of the neurological and neurosurgical community is how to minimize or prevent complications linked to CP. 5,6,12,14,20 …”

Section: Discussionmentioning

confidence: 99%

“…12,14,16,18–20 While a recent literature review described the complications associated with DC, it did not consider the timing of the CP procedure. 21 Another systematic review that involved patients receiving DC for different reasons (i.e., TBI, ischemic/haemorrhagic stroke and other causes) concluded that, compared with late CP (i.e., 3–6 months after DC), early CP (i.e., 1–3 months after DC) was not associated with more complications or an increased risk of hydrocephalus 12 Nevertheless, in patients receiving DC for TBI which is the most common reason for the procedure, the effects of early CP compared with late CP on post-operative complications remains unclear. 5,6,12,14,16,20 Therefore, the aim of this present study was to perform a systematic review and meta-analysis of publications in which authors reported data on post-operative complications following early or late CP following DC for TBI.…”

Section: Introductionmentioning

confidence: 99%

Early or late cranioplasty following decompressive craniotomy for traumatic brain injury: A systematic review and meta-analysis

Zheng

Spreckelsen

et al. 2018

J Int Med Res

Self Cite

View full text Add to dashboard Cite

ObjectiveTo evaluate the effectiveness of early (<3 months) cranioplasty (CP) and late CP (>3 months) on post-operative complications in patients receiving decompressive craniotomy (DC) for traumatic brain injury (TBI).MethodsThe Cochrane Library, PubMed and EMBASE databases were systematically searched for studies published prior to May 21, 2017. A meta-analysis examined post-operative overall complication rates, infection rates, subdural fluid collection and operating times according to early and late CP.ResultsOf the initial 1675 references, five studies, all cohort, involving a total of 413 patients, were selected for the review. There was no difference between early and late CP in post-operative overall complication rate (RR=0.68, 95%CI [0.36, 1.29]) and the post-operative infection rate (RR=0.50, 95%CI [0.20, 1.24]) in patients receiving DC for TBI. However, there was a significant difference in post-operative subdural effusion (RR=0.24, 95%CI [0.07, 0.78]) and mean operative time (mean difference = −33.02 min, 95%CI [−48.19, −17.84]) both in favour of early CP.ConclusionsNo differences were found between early and late CP in post-operative overall complications and procedural related infections in patients receiving DC for TBI, but early CP reduced the complication of subdural effusion and the mean operating time. These findings need to be confirmed by large, randomised controlled trials.

show abstract

“…Another limitation is that all surgeries were performed months after prior craniectomy (late cranioplasty) when the risks of complications and infection are possibly lower when compared to early cranioplasty, although recent systematic reviews did not support this information. [2526]…”

Section: Discussionmentioning

confidence: 99%

Polymethylmethacrylate imbedded with antibiotics cranioplasty: An infection solution for moderate and large defects reconstruction

Worm¹,

Nascimento

Nicola

et al. 2016

Surg Neurol Int

View full text Add to dashboard Cite

Background:In cases where autologous bone graft reconstruction is not possible (such as comminuted fractures, bone graft reabsorption, or infection) and the use of synthetic material is required, polymethylmethacrylate (PMMA) use is a safe and efficient solution. Studies comparing the incidence of postoperative complications between autologous and synthetic cranioplasty are heterogeneous, not allowing a conclusion of which is the best material for skull defects reconstruction. Current medical literature lacks prospective well-delineated studies with long-term follow-up that analyze the impact of antibiotic use in PMMA cranial reconstruction of moderate and large defects.Methods:A prospective series of patients, who underwent cranioplasty reconstruction with PMMA impregnated with antibiotic, were followed for 2 years. Authors collected data regarding demographic status, clinical conditions, surgical information, and its complications.Results:A total of 58 patients completed full follow-up with a mean group age of 40 years and a male predominance (77%). Major complications that required surgical management were identified in 5 patients, and 10 patients evolved with minor complications. Postoperative surgical site infection incidence was 3.2%.Conclusion:The infection rate in patients submitted to PMMA flap cranioplasty impregnated with antibiotic is significantly inferior comparing to the data described in medical literature. A lower infection incidence impacts secondary endpoints such as minimizing surgical morbidity, mortality, hospitalization period, and, consequently, costs.

show abstract

Early cranioplasty vs. late cranioplasty for the treatment of cranial defect: A systematic review

Cited by 88 publications

References 38 publications

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

Diagnostic and prognostic value of procalcitonin for early intracranial infection after craniotomy

Early or late cranioplasty following decompressive craniotomy for traumatic brain injury: A systematic review and meta-analysis

Polymethylmethacrylate imbedded with antibiotics cranioplasty: An infection solution for moderate and large defects reconstruction

Contact Info

Product

Resources

About