Defining “early” cranioplasty to achieve lower complication rates of bone flap failure: resorption and infection

Jang Hun Kim, Soon Young Hwang, Taek-Hyun Kwon, Kyuha Chong, Won Ki Yoon, Jong Hyun Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: 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. Objective: We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
JournalActa Neurochirurgica
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Decompressive Craniectomy
Bone Resorption
Surgical Wound Infection
Bone and Bones
Infection
Survival Analysis
ROC Curve
Multivariate Analysis
Regression Analysis

Keywords

  • Bone flap resorption
  • Cranioplasty
  • Early cranioplasty
  • Optimal timing
  • Surgical site infection

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Defining “early” cranioplasty to achieve lower complication rates of bone flap failure : resorption and infection. / Kim, Jang Hun; Hwang, Soon Young; Kwon, Taek-Hyun; Chong, Kyuha; Yoon, Won Ki; Kim, Jong Hyun.

In: Acta Neurochirurgica, 01.01.2018.

Research output: Contribution to journalArticle

@article{b8627477753447f7a246538b1eb6587f,
title = "Defining “early” cranioplasty to achieve lower complication rates of bone flap failure: resorption and infection",
abstract = "Background: 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. Objective: We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications. Methods: 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. Results: 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. Conclusion: 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.",
keywords = "Bone flap resorption, Cranioplasty, Early cranioplasty, Optimal timing, Surgical site infection",
author = "Kim, {Jang Hun} and Hwang, {Soon Young} and Taek-Hyun Kwon and Kyuha Chong and Yoon, {Won Ki} and Kim, {Jong Hyun}",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s00701-018-3749-8",
language = "English",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",

}

TY - JOUR

T1 - Defining “early” cranioplasty to achieve lower complication rates of bone flap failure

T2 - resorption and infection

AU - Kim, Jang Hun

AU - Hwang, Soon Young

AU - Kwon, Taek-Hyun

AU - Chong, Kyuha

AU - Yoon, Won Ki

AU - Kim, Jong Hyun

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: 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. Objective: We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications. Methods: 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. Results: 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. Conclusion: 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.

AB - Background: 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. Objective: We retrospectively investigated bone flap resorption and surgical site infection after CP to determine the optimal timing of surgery for reduction of complications. Methods: 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. Results: 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. Conclusion: 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.

KW - Bone flap resorption

KW - Cranioplasty

KW - Early cranioplasty

KW - Optimal timing

KW - Surgical site infection

UR - http://www.scopus.com/inward/record.url?scp=85058028504&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058028504&partnerID=8YFLogxK

U2 - 10.1007/s00701-018-3749-8

DO - 10.1007/s00701-018-3749-8

M3 - Article

C2 - 30511143

AN - SCOPUS:85058028504

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

ER -