Defining “early” cranioplasty to achieve lower complication rates of bone flap failure: resorption and infection
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Although cranioplasty (CP) is a frequently performed and simple procedure, complications are common, particularly bone flap resorption and infection. The timing of surgery is as an important contributory factor, but the optimal timing has not been clearly determined.
We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications.
The study enrolled 126 patients who underwent decompressive craniectomy (DC) and subsequent CP. Patients with bone flap resorption or surgical site infection were analyzed as the “complication” group. Receiver operating characteristic curve analysis was performed and the Youden index was used to dichotomize “early CP” and “late CP” groups. Univariate and multivariate survival analyses were performed.
The complication group included 42 patients. The Youden index was used to identify a cutoff value for the DC-CP interval of > 44 days, and this was used to define early (< 45 days) and late (≥ 45 days) CP. Late CP was a significant risk factor in univariate and multivariate Cox regression analyses.
This study showed that early CP before 45 days after DC is associated with a lower rate of bone flap resorption and surgical site infection than late CP.
KeywordsBone flap resorption Cranioplasty Early cranioplasty Surgical site infection Optimal timing
This was supported by Korea University Grant.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee [2017GR0098] and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
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