Predictors of infection after 754 cranioplasty operations and the value of intraoperative cultures for cryopreserved bone flaps

Journal of Neurosurgery
Ryan P MortonRandall M Chesnut

Abstract

OBJECTIVE The authors' aim was to report the largest study on predictors of infection after cranioplasty and to assess the predictive value of intraoperative bone flap cultures before cryopreservation. METHODS They retrospectively examined all cranioplasties performed between March 2004 and November 2014. Throughout this study period, the standard protocol during initial craniectomy was to obtain a culture swab of the extracted autologous bone flap (ABF)-prior to its placement in cytostorage-to screen for microbial contamination. Two consecutive protocols were employed for the use and interpretation of the intraoperative swab culture results: A) From March 2004 through June 2013, any culture-positive ABF (+ABF) was discarded and a custom synthetic prosthesis was implanted at the time of cranioplasty. B) From July 2013 through November 2014, any ABF with a skin flora organism was not discarded. Instead, cryopreservation was maintained and the +ABF was reimplanted after a 10-minute soak in bacitracin irrigation as well as a 3-minute soak in betadine. RESULTS Over the 10.75-year period, 754 cranioplasty procedures were performed. The median time from craniectomy to cranioplasty was 123 days. Median follow-up after cranioplasty was...Continue Reading

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Citations

Jul 21, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Gil KimchiSagi Harnof
Dec 3, 2016·Expert Review of Anti-infective Therapy·Anna ConenAndrej Trampuz
Dec 10, 2016·Acta chirurgica Belgica·Michiel HerteleerFrank Van Calenbergh
Aug 12, 2017·Journal of Neurosurgery·Ryan P MortonRandall M Chesnut
Feb 13, 2018·Neurosurgical Review·David J WallaceJohn R Floyd
May 2, 2019·Acta neurochirurgica·Jimmy SundblomLars Kihlström
Aug 16, 2019·Advanced Healthcare Materials·Baptiste CharbonnierJake Barralet
Jun 25, 2016·Current Opinion in Clinical Nutrition and Metabolic Care·Monika A Krezalek, John C Alverdy
Mar 5, 2020·Neurology India·Murali Mohan SelvamRobin Harshvardhan Gupta
Jan 11, 2021·Cell and Tissue Banking·Vicente MirabetCarlos Botella
Jul 15, 2021·FEMS Microbiology Reviews·Elisa J M RaineriJan Maarten van Dijl
Aug 11, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mehdi ShafieiSaeid Mahram

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