Time Interval Reduction for Delayed Implant-Based Cranioplasty Reconstruction in the Setting of Previous Bone Flap Osteomyelitis

Lopez, Joseph; Zhong, Shuting; Sankey, Eric W.; Swanson, Edward W.; Susarla, Harlyn K.; Jusué-Torres, Ignacio; Huang, Judy; Brem, Henry; Auwaerter, Paul G.; Gordon, Chad R.

doi:10.1097/01.prs.0000475770.14396.1e

Cited by 39 publications

(20 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…94 To reduce the risk of infections as complications, it is generally recommended that patients wait at least 3 months after the injury before repair of a bony deficit is attempted. 58 If the conservative treatment does not promptly improve the clinical condition of a patient, a deep incisional infection should be considered and removal of the biomaterial followed by long-term antibiotic therapy is suggested. 2 To our knowledge, vancomycin used in perioperative prophylaxis significantly reduces the risk of S. aureus surgical site infections (SSIs).…”

Section: Fig 4 Map Of the Distribution Of Irs By Countrymentioning

confidence: 99%

Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections

Chen

Zhang

Qin

et al. 2019

Neurosurgical Focus

View full text Add to dashboard Cite

OBJECTIVEVarious implanted materials are used in neurosurgery; however, there remains a lack of pooled data on infection rates (IRs) and infective bacteria over past decades. The goal of this study was to investigate implant infections in neurosurgical procedures in a longitudinal retrospective study and to evaluate the IRs of neurosurgically implanted materials and the distribution of pathogenic microorganisms.METHODSA systematic literature search was conducted using PubMed and Web of Science databases for the time period between 1968 and 2018. Neurosurgical implant infections were studied in 5 subgroups, including operations or diseases, implanted materials, bacteria, distribution by country, and time periods, which were obtained from the literature and statistically analyzed. In this meta-analysis, statistical heterogeneity across studies was tested by using p values and I2 values between studies of associated pathogens. Egger’s test was used for assessing symmetries of funnel plots with Stata 11.0 software. Methodological quality was assessed to judge the risk of bias according to the Cochrane Handbook.RESULTSA total of 22,971 patients from 227 articles satisfied the study’s eligibility criteria. Of these, 1118 cases of infection were reported, and the overall IR was 4.87%. In this study, the neurosurgical procedures or disorders with the top 3 IRs included craniotomy (IR 6.58%), cranioplasty (IR 5.89%), and motor movement disorders (IR 5.43%). Among 13 implanted materials, the implants with the top 3 IRs included polypropylene-polyester, titanium, and polyetheretherketone (PEEK), which were 8.11%, 8.15%, and 7.31%, respectively. Furthermore, the main causative pathogen was Staphylococcus aureus and the countries with the top 3 IRs were Denmark (IR 11.90%), Korea (IR 10.98%), and Mexico (IR 9.26%). Except for the low IR from 1998 to 2007, the overall implant IR after neurosurgical procedures was on the rise.CONCLUSIONSIn this study, the main pathogen in neurosurgery was S. aureus, which can provide a certain reference for the clinic. In addition, the IRs of polypropylene-polyester, titanium, and PEEK were higher than other materials, which means that more attention should be paid to them. In short, the total IR was high in neurosurgical implants and should be taken seriously.

show abstract

Section: Fig 4 Map Of the Distribution Of Irs By Countrymentioning

confidence: 99%

Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections

Chen

Zhang

Qin

et al. 2019

Neurosurgical Focus

View full text Add to dashboard Cite

show abstract

“…Although we are aware that each alloplastic material has its own unique complication profile, we cannot accurately comment on the efficacy of each specific material because of the relatively low incidence of infections in our 4-year experience. 4,53,59 However, despite these limitations, this is the first study to date that has assessed the impact of perioperative anticoagulant therapy on reconstructive cranioplasty outcomes. Our results, in a deficient area of study within neurosurgery and craniofacial surgery, suggest that caution regarding Fig.…”

Section: Discussionmentioning

confidence: 96%

Anticoagulation for Hypercoagulable Patients Associated with Complications after Large Cranioplasty Reconstruction

Sankey

Lopez

Zhong

et al. 2016

Plastic and Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recent studies have proposed post infection cranioplasty at 12 weeks after osteomyelitic bone fl ap removal instead of the greater than 6 month time intervals previously agreed upon. 24 Early cranioplasty as early as 1 week post-decompression was successfully performed after radiographic evidence of resolution of cerebral edema. 25 Overall complication rates in cranioplasty procedures have been reported to be approximately 4% to 15% in large series.…”

Section: Discussionmentioning

confidence: 99%

“…25 Overall complication rates in cranioplasty procedures have been reported to be approximately 4% to 15% in large series. 24 The average rate of cranioplasty infection is approximately 7.9%. 23 This is comparable to our study with complication rate of 9%.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

Shakya

Thapa

2019

Nep J Neurosci

View full text Add to dashboard Cite

Autologous cranioplasty is an increasingly common procedure performed in neurosurgical centers following a decompressive craniectomy. Available evidence on the safety of autologous bone flap preservation and cranioplasty is limited due to a large diversity in study conducted, nature of pathology and reported outcomes. In this Institutional Review Board-approved retrospective observational study, patients who underwent neurosurgical intervention as“craniectomy followed by cranioplasty” at the Department of Neurological Surgery, Kathmandu Medical College Teaching Hospital were enrolled retrospectively from 1st May 2012 to 30th April2019. The craniectomy bone flap was preserved exvivo, dipped in spirit solution in deep freeze, then autoclaved prior to cranioplasty. Data were collected from the hospital’s electronic database. Information analyzed included patient age, sex, indication forcraniectomy, interval between craniectomy and cranioplasty, length of hospital stay, peri-operativecomplications and mean time of follow-up. Patients who underwent a cranioplasty following removal of an infected bone flap after a craniotomy were excluded from the study. Associated complications were assessed and statistical analysis was performed using a Fisher’s exact test. There were a total of 210 patients with 92vascular, 58 post traumatic. With all these surgeries undergone we had 9% complication rate, all of whom underwent cranioplasty later than four weeks of primary surgery (p = <0.0001).Ex-vivo preservation and autoclaving of bone flap is a simple technique with significant benefits in our hospital and national scenario with significantly less financial burden to patients

show abstract

Time Interval Reduction for Delayed Implant-Based Cranioplasty Reconstruction in the Setting of Previous Bone Flap Osteomyelitis

Abstract: Therapeutic, III.

Cited by 39 publications

References 17 publications

Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections

Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections

Anticoagulation for Hypercoagulable Patients Associated with Complications after Large Cranioplasty Reconstruction

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

Contact Info

Product

Resources

About