Infection Focus after Cranioplasty: A Retrospective Review of a Single Center for a Decade - Review of Infection after Cranioplasty -

초록

Introduction : Postopertive infection including the surgical site infection (SSI) and the bone graft infection after cranioplasty (BIC) is a major concern with cranioplasty. This study reviewed the infection result and identified factors related to postoperative infection after cranioplasty using a single center data for a decade. Material and Method : A total of 92 patients underwent reconstructive cranioplasty after decompressive craniectomy between 2002 and 2012 in a single institude. The sample population included 65 male patients and 27 female patients aged 8 years to 77 years, with a mean age of 43.6 years. Autografts were used for cranioplasty when available and polymethylmethacrylate (PMMA) was considered when autografts were not available. Infections after cranioplasty were confirmed by clinical symptom, laboratory test, and imaging studies, and the related factors were evaluated retrospectively. Results : Infections after crainoplasty were occurred in 18 patients (19.6%). Surgical site infections were 11 cases (12.0%) and bone graft infections were 7 cases (7.6%). Infection rates were similar between the operation intervals from the decompressive craniectomy and cranioplasty (p-value=0.727, less or more than 90 days), but increased significantly by the operation time during cranioplasty (p-value=0.048, less or more than 2 hours, but not different by less or more than 3 hours with p-value=0.948). Other factors such as graft material, age, sex, the cranioplasty conducted year, the operated surgeons, the cause of the decompression surgery, and underlying nondiabetic diseases did not significantly alter the infection rate. The most common pathogen in SSI and BIC was methicillin-resistant Staphylococcus aures (MRSA) in 15 cases (83.3% of SSI and 72.7% of BIC), and other minor pathogens were vancomycin-resistant Enterococcus and Corynebacterium with each 1 case. Conclusions : Postoperative infection was developed by mainly MRSA, and short operation t