Management and prevention of cranioplasty infections

Frassanito, Paolo; Fraschetti, Flavia; Giovannenze, Francesca; Caldarelli, Massimo; Scoppettuolo, Giancarlo

doi:10.1007/s00381-019-04251-8

Cited by 34 publications

(26 citation statements)

References 51 publications

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“…The titanium alloy, Ti-6Al-4V, is a common substrate for medical implants due to its biocompatibility, corrosion resistance, and mechanical properties which are suitable for a wide variety of applications. Metallic implants made from titanium alloys have also been shown to result in lower post-operative infection rates compared to polymeric alternatives [10], making it an attractive alternative material. Titanium is generally considered non-magnetic, generating insignificant forces in a strong magnetic field, and safe to be present in a clinical MRI system without risk of injury to the patient.…”

Section: Introductionmentioning

confidence: 99%

Reducing MRI susceptibility artefacts in implants using additively manufactured porous Ti-6Al-4V structures

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Reducing MRI susceptibility artefacts in implants using additively manufactured porous Ti-6Al-4V structures

et al. 2020

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“…Infection is a known and frequently reported complication of cranioplasty [6,8,[12][13][14][15][16]. This retrospective study found that infection was the most common complication reported overall.…”

Section: Discussionmentioning

confidence: 89%

“…One method of infection management proposed in the literature is creating adequate revascularization to ensure optimal uptake of antibiotics by tissues [ 13 ]. Zhang et al also reported that adding anti-infective nanoparticles including silver nanoparticles, silk fibroin/gentamicin sulfate, and hydroxyfluorapatite to the surfaces of PEEK implants may help reduce infection rates [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Characterizing Adverse Events of Cranioplasty Implants After Craniectomy: A Retrospective Review of the Federal Manufacturer and User Facility Device Experience Database

Hacherl¹,

Patel²,

Jones³

et al. 2021

Cureus

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IntroductionCranioplasty is performed by placing an artificial plate in place of a patient's native skull bones to repair post-craniectomy defects after trauma. Implanted materials can range from titanium to synthetic polyether derivatives and are produced by multiple manufacturers. There are few studies characterizing complications associated with these cranioplasty plates to date. We aimed to quantify and categorize complications of these devices using a national federal database. MethodsThe Manufacturer and User Facility Device Experience (MAUDE) database was queried for all entries reported under the category "plate, cranioplasty, preformed, non-alterable" with the additional product code GXN between the time range from September 1, 2010, to September 1, 2020. After data extraction, each of the entries was screened for duplicates and tabulated into different categories of complications. Additionally, product information such as the plate manufacturer was extracted from each entry. ResultsThe search yielded 329 unique event reports. The most frequent complications were infection (39%), followed by incorrectly fitting implants (30%) and implant breaks (6%). Other major complications included cerebrospinal fluid leakage and cerebral edema (5%), wound dehiscence (5%), and migration of hardware (3%). The brands associated with the most entries in the database were the Synthes (DePuy Synthes Companies, Massachusetts, United States) polyetheretherketone (PEEK) patient-specific implants (PSI) (57%), the Biomet (Zimmer Biome, Indiana, United States) hard tissue replacementpolyetherketoneketone (HTR-PEKK) patient-matched implant (PMI) (23%), and the AccuShape PEEK PSI (MedCAD, Dallas, USA) (5%). ConclusionsInfection and improperly fitting implants appear to be the two most frequent complications of cranioplasty plates. The goals of future research should include the prevention of plate infections as well as improving techniques to custom-fit implantable devices.

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“…Infection rates may vary among patients receiving custom implants, and infection is still the most common complication in cranioplasty surgery with variable incidence rates. Regardless of the selected method, the timing of cranioplasty, patient's performance, choice of the material, and surgical running time affect the risk of complications [12,16,23,1,30,22,9]. PMMA often exhibits low complication rates in cranioplasty [16,6,7,33,15,8,26,3].…”

Section: Discussionmentioning

confidence: 99%

Cranioplasty with three-dimensional customised mould for polymethylmethacrylate implant: a series of 11 consecutive patients with cost-effectiveness consideration

Silva

Aragão

Loureiro

et al. 2020

Preprint

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Background Different methods of cranioplasty for the reconstruction of bony skull defects exist. In the absence of the autologous bone flap, a customised manufactured implant may be the optimal choice, but this implant has several limitations regarding its technical standardisation and better cost-effectiveness. Methods This study presents a series of 11 consecutive patients who had undergone cranioplasty with customised three-dimensional (3D) template moulds for polymethylmethacrylate (PMMA) implants manufactured after 3D modelling on a specific workstation. The virtual images were transformed into a two-piece physical model using a 3D printer for the biomaterials. PMMA implant was produced intraoperatively with the custom mould. Cosmetic results were analysed by comparing pre- and postoperative 3D computed tomography (CT) images and asking if the patient was satisfied with the result. Results The average total time for planning and production of customised mould was 10 days. The 11 patients were satisfied with the result, and CT images presented harmonious symmetry when comparing pre- and postoperative scans. Cases of postoperative infection, bleeding, or reoperation in this series were not observed. Conclusion Cranioplasty with high-technology customised 3D moulds for PMMA implants can allow for an aesthetic reconstruction with a fast and cost-effective manufacturing process and possibly with low complication rates.

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Management and prevention of cranioplasty infections

Cited by 34 publications

References 51 publications

Reducing MRI susceptibility artefacts in implants using additively manufactured porous Ti-6Al-4V structures

Reducing MRI susceptibility artefacts in implants using additively manufactured porous Ti-6Al-4V structures

Characterizing Adverse Events of Cranioplasty Implants After Craniectomy: A Retrospective Review of the Federal Manufacturer and User Facility Device Experience Database

Cranioplasty with three-dimensional customised mould for polymethylmethacrylate implant: a series of 11 consecutive patients with cost-effectiveness consideration

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