Ali Alkhaibary1, Ahoud Alharbi2, Munzir Abbas3, Abdulaziz Algarni3, Jamal M Abdullah4, Wedad H Almadani5, Ibtesam Khairy6, Ahmed Alkhani3, Ahmed Aloraidi3, Sami Khairy3. 1. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Electronic address: AlkhaibaryA@hotmail.com. 2. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 3. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Neurosurgery, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. 4. College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. 5. National Center for Evidence Based Healthcare, Saudi Health Council, Riyadh, Saudi Arabia. 6. Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia.
Abstract
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.
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.
Authors: Erasmo Barros da Silva Júnior; Afonso Henrique de Aragão; Marcelo de Paula Loureiro; Caetano Silva Lobo; Ana Flávia Oliveti; Rafael Martinelli de Oliveira; Ricardo Ramina Journal: 3D Print Med Date: 2021-02-06
Authors: Ahmed Aloraidi; Ali Alkhaibary; Ahoud Alharbi; Nada Alnefaie; Abeer Alaglan; Abdulaziz AlQarni; Turki Elarjani; Ala Arab; Jamal M Abdullah; Abdulaziz Oqalaa Almubarak; Munzir Abbas; Ibtesam Khairy; Wedad H Almadani; Mohammed Alowhaibi; Abdulaziz Alarifi; Sami Khairy; Ahmed Alkhani Journal: Surg Neurol Int Date: 2021-06-07