Cranioplasty infection
Cranioplasty still has one of the highest rates of infection.
Cranioplasty infection can lead to reoperation, long-term antibiotic use, and significant morbidity 1) 2) 3) 4) 5) 6) 7).
Patients with a ventriculoperitoneal shunt tend to develop epidural fluid accumulation after cranioplasty and also have a higher frequency of syndrome of the trephined after bone flap removal. Thus treatment of patients with postcranioplasty infection and a VP shunt is often challenging.
Risk factors
Clinical features
Fever, local signs of inflammation (swelling and/or redness at the operated site), wound drainage and/or dehiscence, wound pain/headaches, seizures, and focal neurological deficits
Prevention
Treatment
Hostile sites
Hostile sites for cranioplasty occur in patients with a history of radiation, infection, failed cranioplasty, CSF leak or acute infection.
The incidence of SSI in cranioplasty was associated with modifiable risk factors, i.e., blood glucose levels and skull defect size. Storing bone flaps in subcutaneously preserved abdominal pockets was cost-efficient and carried no additional risk of infection 8).