Retrospective study of infection rate in cranioplasty cases at tertiary care centre

Abstract

Background: Various studies indicate that the infection rate in post operative cranioplasty cases is up to 26%. Infection rate depends on material used for cranioplasty and it is more with metal implant material. We retrospectively reviewed the infection rate at our institute for the cases operated over last five years. Methods: we studied case records of 180 cranioplasty cases over last 10 years. Majority of the cases were operated for trauma. Cranioectomy due to non trauma causes were not included. Results: After studying these patients we found that 30 patients had post operative infection among our cases. Persistant use of same head dressing applied immediately after operation seems to be a significant risk factor for operative wound infection. The relative risk for which was 15.30. Fourteen out of 30 patients needed debridement and daily dressing with antiseptic solutions, and eight required revision of scalp flap with the help from plastic surgeon. All patients improved and did well after treatment. Conclusions: There is always a chance of infection in cranioplasty cases even after utmost antisepsis . Contamination due to trauma and application of bandage for long appears to the precipitating factors for infection. This study confirms that there needs a practice change with proper antiseptic techniques right from triage room to the post-operative care room to minimize the chances of infection.