Journal of Korean Neurosurgical Society

  • 제52권4호
  • /
  • Pages.396-403
  • /
  • 2012
  • /
  • 2005-3711(pISSN)
  • /
  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지
DOI QR코드

DOI QR Code

Long-Term Incidence and Predicting Factors of Cranioplasty Infection after Decompressive Craniectomy

  • Im, Sang-Hyuk (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jang, Dong-Kyu (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Han, Young-Min (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Jong-Tae (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Chung, Dong Sup (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Park, Young Sup (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 투고 : 2012.05.06
  • 심사 : 2012.10.04
  • 발행 : 2012.10.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective : The predictors of cranioplasty infection after decompressive craniectomy have not yet been fully characterized. The objective of the current study was to compare the long-term incidences of surgical site infection according to the graft material and cranioplasty timing after craniectomy, and to determine the associated factors of cranioplasty infection. Methods : A retrospective cohort study was conducted to assess graft infection in patients who underwent cranioplasty after decompressive craniectomy between 2001 and 2011 at a single-center. From a total of 197 eligible patients, 131 patients undergoing 134 cranioplasties were assessed for event-free survival according to graft material and cranioplasty timing after craniectomy. Kaplan-Meier survival analysis and Cox regression methods were employed, with cranioplasty infection identified as the primary outcome. Secondary outcomes were also evaluated, including autogenous bone resorption, epidural hematoma, subdural hematoma and brain contusion. Results : The median follow-up duration was 454 days (range 10 to 3900 days), during which 14 (10.7%) patients suffered cranioplasty infection. There was no significant difference between the two groups for event-free survival rate for cranioplasty infection with either a cryopreserved or artificial bone graft (p=0.074). Intergroup differences according to cranioplasty time after craniectomy were also not observed (p=0.083). Poor neurologic outcome at cranioplasty significantly affected the development of cranioplasty infection (hazard ratio 5.203, 95% CI 1.075 to 25.193, p=0.04). Conclusion : Neurologic status may influence cranioplasty infection after decompressive craniectomy. A further prospective study about predictors of cranioplasty infection including graft material and cranioplasty timing is necessary.

키워드

참고문헌

  1. Aarabi B, Hesdorffer DC, Ahn ES, Aresco C, Scalea TM, Eisenberg HM : Outcome following decompressive craniectomy for malignant swelling due to severe head injury. J Neurosurg 104 : 469-479, 2006 https://doi.org/10.3171/jns.2006.104.4.469
  2. Asano Y, Ryuke Y, Hasuo M, Simosawa S : [Cranioplasty using cryopreserved autogenous bone]. No To Shinkei 45 : 1145-1150, 1993
  3. Chang V, Hartzfeld P, Langlois M, Mahmood A, Seyfried D : Outcomes of cranial repair after craniectomy. J Neurosurg 112 : 1120-1124, 2010 https://doi.org/10.3171/2009.6.JNS09133
  4. Cheng YK, Weng HH, Yang JT, Lee MH, Wang TC, Chang CN : Factors affecting graft infection after cranioplasty. J Clin Neurosci 15 : 1115- 1119, 2008 https://doi.org/10.1016/j.jocn.2007.09.022
  5. Dujovny M, Aviles A, Agner C, Fernandez P, Charbel FT : Cranioplasty : cosmetic or therapeutic? Surg Neurol 47 : 238-241, 1997 https://doi.org/10.1016/S0090-3019(96)00013-4
  6. Fiorot Jr JA, Silva GS, Cavalheiro S, Massaro AR : Use of decompressive craniectomy in the treatment of hemispheric infarction. Arq Neuropsiquiatr 66 : 204-208, 2008 https://doi.org/10.1590/S0004-282X2008000200012
  7. Gooch MR, Gin GE, Kenning TJ, German JW : Complications of cranioplasty following decompressive craniectomy : analysis of 62 cases. Neurosurg Focus 26 : E9, 2009
  8. Honeybul S, Ho KM : Long-term complications of decompressive craniectomy for head injury. J Neurotrauma 28 : 929-935, 2011 https://doi.org/10.1089/neu.2010.1612
  9. Huang YH, Yang TM, Lee TC, Chen WF, Yang KY : Acute autologous bone flap infection after cranioplasty for postinjury decompressive craniectomy. Injury 2011 [Epub ahead of print]
  10. Inamasu J, Kuramae T, Nakatsukasa M : Does difference in the storage method of bone flaps after decompressive craniectomy affect the incidence of surgical site infection after cranioplasty? Comparison between subcutaneous pocket and cryopreservation. J Trauma 68 : 183-187; discussion 187, 2010 https://doi.org/10.1097/TA.0b013e3181c45384
  11. Iwama T, Yamada J, Imai S, Shinoda J, Funakoshi T, Sakai N : The use of frozen autogenous bone flaps in delayed cranioplasty revisited. Neurosurgery 52 : 591-596; discussion 595-596, 2003
  12. Jho DH, Neckrysh S, Hardman J, Charbel FT, Amin-Hanjani S : Ethylene oxide gas sterilization : a simple technique for storing explanted skull bone. Technical note. J Neurosurg 107 : 440-445, 2007 https://doi.org/10.3171/JNS-07/08/0440
  13. Kim YW, Yoo DS, Kim DS, Huh PW, Cho KS, Kim JG, et al. : The infection rate in case of cranioplasty according to used materials and skulldefect duration. J Korean Neurosurg Soc 30 : S216-S220, 2001
  14. Lee SC, Wu CT, Lee ST, Chen PJ : Cranioplasty using polymethyl methacrylate prostheses. J Clin Neurosci 16 : 56-63, 2009 https://doi.org/10.1016/j.jocn.2008.04.001
  15. Matsuno A, Tanaka H, Iwamuro H, Takanashi S, Miyawaki S, Nakashima M, et al. : Analyses of the factors influencing bone graft infection after delayed cranioplasty. Acta Neurochir (Wien) 148 : 535-540; discussion 540, 2006 https://doi.org/10.1007/s00701-006-0740-6
  16. Murthy JM, Chowdary GV, Murthy TV, Bhasha PS, Naryanan TJ : Decompressive craniectomy with clot evacuation in large hemispheric hypertensive intracerebral hemorrhage. Neurocrit Care 2 : 258-262, 2005 https://doi.org/10.1385/NCC:2:3:258
  17. Nagayama K, Yoshikawa G, Somekawa K, Kohno M, Segawa H, Sano K, et al. : [Cranioplasty using the patient's autogenous bone preserved by freezing--an examination of post-operative infection rates]. No Shinkei Geka 30 : 165-169, 2002
  18. Otani N, Takasato Y, Masaoka H, Hayakawa T, Yoshino Y, Yatsushige H, et al. : Surgical outcome following decompressive craniectomy for poorgrade aneurysmal subarachnoid hemorrhage in patients with associated massive intracerebral or Sylvian hematomas. Cerebrovasc Dis 26 : 612- 617, 2008 https://doi.org/10.1159/000165115
  19. Patir R, Mahapatra AK, Banerji AK : Risk factors in postoperative neurosurgical infection. A prospective study. Acta Neurochir (Wien) 119 : 80-84, 1992 https://doi.org/10.1007/BF01541786
  20. Qiu W, Guo C, Shen H, Chen K, Wen L, Huang H, et al. : Effects of unilateral decompressive craniectomy on patients with unilateral acute post-traumatic brain swelling after severe traumatic brain injury. Crit Care 13 : R185, 2009 https://doi.org/10.1186/cc8178
  21. Shoakazemi A, Flannery T, McConnell RS : Long-term outcome of subcutaneously preserved autologous cranioplasty. Neurosurgery 65 : 505- 510; discussion 510, 2009 https://doi.org/10.1227/01.NEU.0000350870.69891.86
  22. Thavarajah D, De Lacy P, Hussien A, Sugar A : The minimum time for cranioplasty insertion from craniectomy is six months to reduce risk of infection--a case series of 82 patients. Br J Neurosurg 26 : 78-80, 2012 https://doi.org/10.3109/02688697.2011.603850
  23. Yadla S, Campbell PG, Chitale R, Maltenfort MG, Jabbour P, Sharan AD : Effect of early surgery, material, and method of flap preservation on cranioplasty infections : a systematic review. Neurosurgery 68 : 1124- 1129; discussion 1130, 2011
  24. Zhao Z, Yu J, Liao S, Xiong L, Liang Z, Ling L, et al. : Delayed decompressive craniectomy improves the long-term outcomes in hypertensive rats with space-occupying cerebral infarction. Neurocrit Care 7 : 263- 269, 2007 https://doi.org/10.1007/s12028-007-0074-0

피인용 문헌

  1. Predictors of Infections following Cranioplasty: A Retrospective Review of a Large Single Center Study vol.2014, pp.None, 2014, https://doi.org/10.1155/2014/356042
  2. A Preliminary Report on the Use of Antibiotic-Impregnated Methyl Methacrylate in Salvage Cranioplasty vol.25, pp.2, 2014, https://doi.org/10.1097/scs.0000000000000655
  3. Complications of titanium cranioplasty-a retrospective analysis of 174 patients vol.156, pp.5, 2012, https://doi.org/10.1007/s00701-014-2024-x
  4. Complications Associated with Decompressive Craniectomy: A Systematic Review vol.23, pp.2, 2012, https://doi.org/10.1007/s12028-015-0144-7
  5. Cranioplasty complications and risk factors associated with bone flap resorption vol.23, pp.1, 2012, https://doi.org/10.1186/s13049-015-0155-6
  6. Sonication assisted microbiological diagnosis of implant-related infection caused by Prevotella disiens and Staphylococcus epidermidis in a patient with cranioplasty vol.8, pp.None, 2015, https://doi.org/10.1186/s13104-015-1274-x
  7. Bone Flap Resorption Following Cranioplasty after Decompressive Craniectomy: Preliminary Report vol.11, pp.1, 2015, https://doi.org/10.13004/kjnt.2015.11.1.1
  8. Analyses Using Micro-CT Scans and Tissue Staining on New Bone Formation and Bone Fusion According to the Timing of Cranioplasty via Frozen Autologous Bone Flaps in Rabbits : A Preliminary Report vol.57, pp.4, 2015, https://doi.org/10.3340/jkns.2015.57.4.242
  9. Delayed Cranioplasty: Outcomes Using Frozen Autologous Bone Flaps vol.8, pp.3, 2015, https://doi.org/10.1055/s-0034-1395383
  10. Prophylactic Effect of Vancomycin on Infection after Cranioplasty in Methicillin-Resistant Staphylococcus Aureus Carriers with Traumatic Brain Injury vol.11, pp.2, 2012, https://doi.org/10.13004/kjnt.2015.11.2.81
  11. Letter to the Editor: Cranioplasty after decompressive craniectomy vol.125, pp.6, 2012, https://doi.org/10.3171/2016.5.jns161142
  12. Which One Is Better to Reduce the Infection Rate, Early or Late Cranioplasty? vol.59, pp.5, 2012, https://doi.org/10.3340/jkns.2016.59.5.492
  13. Polymethylmethacrylate imbedded with antibiotics cranioplasty: An infection solution for moderate and large defects reconstruction? vol.7, pp.29, 2012, https://doi.org/10.4103/2152-7806.193725
  14. Cranioplasty with autogenous bone flaps cryopreserved in povidone iodine: a long-term follow-up study vol.127, pp.6, 2012, https://doi.org/10.3171/2016.8.jns16204
  15. Cranioplasty with autogenous bone flaps cryopreserved in povidone iodine: a long-term follow-up study vol.127, pp.6, 2012, https://doi.org/10.3171/2016.8.jns16204
  16. Cranioplasty and Craniofacial Reconstruction: A Review of Implant Material, Manufacturing Method and Infection Risk vol.7, pp.3, 2012, https://doi.org/10.3390/app7030276
  17. A case series of early and late cranioplasty—comparison of surgical outcomes vol.161, pp.3, 2012, https://doi.org/10.1007/s00701-019-03820-9
  18. Autogenous Bone Graft versus Artificial Substitutes in Cranioplasty vol.9, pp.3, 2012, https://doi.org/10.4236/ojmn.2019.93032
  19. Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections vol.47, pp.2, 2019, https://doi.org/10.3171/2019.5.focus18582
  20. Evaluation of neurosurgical implant infection rates and associated pathogens: evidence from 1118 postoperative infections vol.47, pp.2, 2019, https://doi.org/10.3171/2019.5.focus18582
  21. The impact of implant material and patient age on the long-term outcome of secondary cranioplasty following decompressive craniectomy for severe traumatic brain injury vol.162, pp.4, 2020, https://doi.org/10.1007/s00701-020-04243-7
  22. Comparison of complications in cranioplasty with various materials: a systematic review and meta-analysis vol.34, pp.4, 2012, https://doi.org/10.1080/02688697.2020.1742291
  23. Cranioplasty with Autologous Bone Flaps Cryopreserved with Dimethylsulphoxide: Does Tissue Processing Matter vol.149, pp.None, 2012, https://doi.org/10.1016/j.wneu.2021.01.131
  24. Clinical evaluation of rapid 3D print‐formed implants for surgical reconstruction of large cranial defects vol.91, pp.6, 2021, https://doi.org/10.1111/ans.16361
  25. The Materials Utilized in Cranial Reconstruction: Past, Current, and Future vol.29, pp.3, 2012, https://doi.org/10.1177/2292550320928560
  26. Complications of Cranioplasty in Relation to Material: Systematic Review, Network Meta-Analysis and Meta-Regression vol.89, pp.3, 2012, https://doi.org/10.1093/neuros/nyab180