Cranioplasty infection risk factors [Neurosurgery Wiki]

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====== Cranioplasty infection risk factors ======

===== Latest Pubmed Related Articles =====


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see also [[Surgical site infection risk factors]].

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The factors contributing to the high rate of [[surgical site infection]] (SSI) after cranioplasty are not well established.__

Patients with multiple [[wound_healing#factors_affecting_wound_healing|wound healing risk factors]] are at higher risk for [[reoperation]]
((Potter T, Murayi R, Ahorukomeye P, Petitt JC, Jarmula J, Krywyj M, Momin A, Recinos PF, Mohammadi AM, Angelov L, Barnett GH, Kshettry VR. Immediate Titanium Mesh Cranioplasty After Debridement and Craniectomy for Postcraniotomy Surgical Site Infections and Risk Factors for Reoperation. World Neurosurg. 2022 Dec 14:S1878-8750(22)01762-4. doi: 10.1016/j.wneu.2022.12.057. Epub ahead of print. PMID: 36526227.)).
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Patients with craniosynostosis as a reason for [[cranioplasty]] have a higher risk of requiring revision or additional surgeries, regardless of the implant used
((Still ME, Samant S, Alvarado A, Neal D, Governale LS, Ching JA. Considerations for choice of cranioplasty material for pediatric patients. Pediatr Neurosurg. 2022 Dec 7. doi: 10.1159/000528543. Epub ahead of print. PMID: 36477047.)).
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Diabetes, hepatic failure, and trauma are significant risk factors for [[cranioplasty complications]]. There was no statistical difference in the incidence of complications between the use of autologous and artificial bones
((Nam HH, Ki HJ, Lee HJ, Park SK. Complications of Cranioplasty Following Decompressive Craniectomy: Risk Factors of Complications and Comparison Between Autogenous and Artificial Bones. Korean J Neurotrauma. 2022 Sep 1;18(2):238-245. doi: 10.13004/kjnt.2022.18.e40. PMID: 36381455; PMCID: PMC9634322.))
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There were no differences in overall postoperative and post-discharge complication rates between the titanium mesh and PEEK. A history of VPS before cranioplasty was an independent risk factor for postoperative overall complications, and infection was a risk factor for implant failure. Finally, depression skull defects and titanium mesh implants increased the incidence of postoperative pneumocephalus
((Yao S, Zhang Q, Mai Y, Yang H, Li Y, Zhang M, Zhang R. Outcome and risk factors of complications after cranioplasty with polyetheretherketone and titanium mesh: A single-center retrospective study. Front Neurol. 2022 Sep 21;13:926436. doi: 10.3389/fneur.2022.926436. PMID: 36212642; PMCID: PMC9533107.))
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Hydroxyapatite and acrylic were associated with reduced risk of all-cause explantation and explantation due to infection. Cranioplasty insertion at three to six months was associated with an increased risk of explantation due to infection
((Millward CP, Doherty JA, Mustafa MA, Humphries TJ, Islim AI, Richardson GE, Clynch AL, Gillespie CS, Keshwara SM, Kolamunnage-Dona R, Brodbelt AR, Jenkinson MD, Duncan C, Sinha A, McMahon CJ. Cranioplasty with hydroxyapatite or acrylic is associated with a reduced risk of all-cause and infection-associated explantation. Br J Neurosurg. 2022 Jun;36(3):385-393. doi: 10.1080/02688697.2022.2077311. Epub 2022 May 24. PMID: 35608052.)).
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Thorough knowledge and understanding of [[cranioplasty infection]] [[risk factor]]s may lead to surgical strategies and bundles, aiming to reduce infectious complications of cranioplasty. Finally, innovation in materials used for cranial repair should also aim to enhance the antimicrobial properties of these inert materials
((Frassanito P, Fraschetti F, Bianchi F, Giovannenze F, Caldarelli M, Scoppettuolo G. Management and prevention of cranioplasty infections. Childs Nerv Syst. 2019 Sep;35(9):1499-1506. doi: 10.1007/s00381-019-04251-8. Epub 2019 Jun 20. PMID: 31222447.)).
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The risk of complication is increased with bifrontal bone defects.