Background: Decompressive craniectomy (DC) is a surgical procedure performed to manage intracranial hypertension. Once performed, patients are obligated to undergo another surgical procedure known as cranioplasty to reconstruct the cranial defect. Cranioplasty still has one of the highest rates of infection. The factors contributing to the high rate of surgical site infection (SSI) after cranioplasty are not well established. This study aims to estimate the incidence of SSI and determine its possible risk factors for patients who underwent cranioplasty using bone flaps subcutaneously preserved in abdominal pockets.
Methods: A retrospective cohort study was conducted to investigate the predictors of infection among patients who underwent cranioplasty from subcutaneously preserved bone flaps in abdominal pockets between January 2005 and December 2018 at a level l trauma center.
Results: A total of 103 cases of cranioplasty from subcutaneously preserved bone flaps were included in the study. The mean age of the patients was 31.2 ± 14.8 years (range, 5-67 years). The median interval between DC and cranioplasty was 115 days. The most frequent indication for DC was traumatic brain injury (76.4%). The incidence of SSI was noted in 15.7% of patients. The most significant predictors of infection in patients requiring cranioplasty were blood glucose levels and skull defect size (P = 0.03 and P = 0.02, respectively).
Conclusions: Blood glucose levels and skull defect size were the only identifiable risk factors associated with SSI. Storing bone flaps in subcutaneous abdominal pockets is cost-efficient but carries considerable risk of infection.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.wneu.2019.09.120 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Limited Reconstructive Options of Jaw Osteomyelitis in the Osteopetrosis Patient Complicated by Blood Dyscrasia.
J Craniofac Surg
January 2025
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
Osteopetrosis is a rare systemic skeletal disorder characterized by increased bone density and mass resulting from suboptimal or impaired resorption of osteoclastic bone. Compromised bone marrow function and associated disorders of red blood cells contribute to hematopoietic abnormalities, which exacerbate the risk of complex, recurrent infections such as jaw osteomyelitis. This case report describes the treatment of a 68-year-old Korean female with autosomal-dominant osteopetrosis who presented with severe and persistent jaw osteomyelitis complicated by hematopoietic dysregulation.
View Article and Find Full Text PDFAnatomical study of the vascularization of the pedicled osteo-myo-cutaneous scapulo-dorsal flap.
Surg Radiol Anat
January 2025
Maxillo-Facial Surgery Department, Beaujon University Hospital, Clichy, France.
Purpose: The main objective of this study was to conduct a radioanatomical study of the osteo-myo-cutaneous scapulo-dorsal pedicled flap.
Methods: A radiological study was performed to study the anatomical variations of the dorsal scapular pedicle (origin, course of the deep branch of the dorsal scapular artery (DSA) in relation to the medial border of the scapula, perforators from the superficial branch of the DSA). Perforators from the superficial branch of the DSA were also identified on anatomical subjects, and their cutaneous vascular territory was determined.
Pedicle ossification following mandibular reconstruction using fibular free flap in a patient with osteoradionecrosis of the jaw: a case report.
J Korean Assoc Oral Maxillofac Surg
December 2024
Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Article Synopsis
- Pedicle ossification is a rare complication that can occur after using a fibular free flap (FFF) for mandibular reconstruction, potentially simulating tumor recurrence and leading to diagnostic challenges.
- A case study of a 38-year-old male with squamous cell carcinoma highlighted how postoperative complications led to the need for FFF reconstruction, and over 4 years, CT scans showed ossification in the flap's vascular pedicle, yet the patient remained asymptomatic.
- Regular imaging and clinical assessments are key to distinguishing ossification from tumor recurrence, with surgery usually only considered if symptoms arise.
The clinical application of adipofascial turnover flaps for coverage of severe burn wounds on the digits.
Ann Burns Fire Disasters
December 2024
Plastic, Reconstructive and Aesthetic Surgery Center, National Burn Hospital, Ha Noi, Viet Nam.
This article presents particular occupational burn injuries resulting in a complex defect of the digits. Nine patients with exposed bone or tendon wounds on the digits were successfully treated using the pedicle adipofascial turnover flap overlaid with skin grafts. Electrical and high-temperature contact burns resulted in five and four severe cases, respectively.
View Article and Find Full Text PDFAnatomical basis and clinical application of the dorsal metacarpal cutaneous branch flap of radial digital artery of index finger.
Surg Radiol Anat
December 2024
Department of Hand-Foot Microsurgery, Shenzhen Nanshan People's Hospital, No. 89 Taoyuan Road, Nanshan District, Shenzhen, 518052, China.
Objective: This study explored the surgical technique and clinical application of the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.
Methods: Through the anatomical dissection of 10 hand specimens, we examined the origin and characteristics of the artery and its branches towards the hand dorsum. Furthermore, the soft tissue defects of the index finger in 12 patients admitted to our hospital between 2017 and 2021 were surgically repaired using the dorsal metacarpal cutaneous branch flap of the radial digital artery of the index finger.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!