Document Detail


Late infection after cranioplasty--review of 14 cases.
MedLine Citation:
PMID:  2477724     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence of late infection after cranioplasty was studied in 130 patients with 133 cranioplasties. The materials used were prefabricated resin in 62 cases, autogenic bone in 38, intraoperatively fashioned resin in 25, and vitallium in eight. Six infections were documented, for an infection rate of 4.5%. In addition to these six cases, we studied eight patients with infections who had undergone cranioplasty elsewhere but had the infected plates removed in our hospitals. Among the 14 cases of infection, the intervals between cranioplasty and plate removal were 3 to 43 months (average, 10.5 months). The eight patients referred from other hospitals had a significantly shorter average interval between external decompression and cranioplasty than did patients who did not develop infection (2.6 versus 6.7 months; p less than 0.005). Systemic signs were mild despite obvious local signs of infection. Of the 11 first infections, nine (82%) were associated with discharge of pus from a fistula; in these cases a galeal suture had become infected apparently through scratching by the patients. In contrast, in the three patients who had had a previous infection, the second infection manifested as subgaleal and epidural empyema or meningitis without a fistula or pus discharge. Nine infections (69%) were due to Staphylococcus. All but two patients required removal of the infected plates. One recovered with conservative therapy and one died of meningitis, giving a mortality rate of 0.8%. No matter how mild the systemic signs, late infection warrants surgical debridement and plate removal. The risk factors for late infection of cranioplasty are discussed.
Authors:
K Tokoro; Y Chiba; K Tsubone
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Neurologia medico-chirurgica     Volume:  29     ISSN:  0470-8105     ISO Abbreviation:  Neurol. Med. Chir. (Tokyo)     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-10-31     Completed Date:  1989-10-31     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0400775     Medline TA:  Neurol Med Chir (Tokyo)     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  196-201     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bacterial Infections / etiology*
Bone Transplantation
Female
Humans
Male
Middle Aged
Postoperative Complications*
Prostheses and Implants
Resins, Plant
Risk Factors
Skull / surgery*
Chemical
Reg. No./Substance:
0/Resins, Plant

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