自体颅骨成形术后减少感染可能与气门下引流有关:一项回顾性分析。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2021-11-09 DOI:10.1080/02688697.2021.1995588
Carole S L Spake, Dardan Beqiri, Vinay Rao, Joseph W Crozier, Konstantina A Svokos, Albert S Woo
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引用次数: 0

摘要

背景:自体骨通常是颅骨减压切除术后颅骨成形术的首选。然而,感染是一种常见的并发症,据报道感染率高达 25%。虽然感染的发生率和处理方法已有详细记录,但与感染相关的风险因素仍不太清楚。本研究旨在确定自体颅骨成形术后感染风险的预测因素:方法:对 2010 年至 2020 年期间使用低温保存的自体骨瓣接受减压开颅术和颅骨成形术的患者进行了回顾性分析。病历记录了患者的人口统计学特征以及与这两项手术和感染率相关的因素。我们进行了逻辑回归,以确定哪些因素与感染的发生有关:我们的队列中有 126 名患者接受了自体颅骨成形术。共有 10 名患者(7.9%)在重建后发生感染,其中一半导致植入失败。我们没有发现任何重要的感染风险因素。回归分析表明,在颅骨成形术后置入气门下引流管是防止感染发生的保护因素(OR:0.16,p = 0.007)。引流管平均留置3天,感染者与非感染者的引流时间没有差异(p = 0.757):本研究显示,在颅骨减压切除术后接受自体颅骨成形术的患者中,感染率为 7.9%,这与之前的数据一致。感染患者中有一半(4%)最终需要移除植入物。虽然使用引流管防止血肿和积液是神经外科医生的常见做法,但我们发现,在颅骨成形术后放置球下引流管与减少感染有关,从而证明了这一常用工具的另一个益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Subgaleal drains may be associated with decreased infection following autologous cranioplasty: a retrospective analysis.

Background: Autologous bone is often the first choice in cranioplasty following a decompressive craniectomy. However, infection is a common complication, with reported rates up to 25%. While the incidence and management of infection are well documented, the risk factors associated with infection remain less clear. The current study aims to identify predictors of infection risk following autologous cranioplasty.

Methods: A retrospective analysis was conducted on patients who underwent decompressive craniectomy and cranioplasty using cryopreserved autologous bone flaps between 2010 and 2020. Patient demographics and factors related to both surgeries and infection rates were recorded from patient records. Logistic regressions were conducted to determine which factors were implicated in the development of infection.

Results: In our cohort, 126 patients underwent autologous cranioplasty. A total of 10 patients (7.9%) developed an infection following reconstruction, with half resulting in implant failure. We did not identify any significant risk factors for infection. Regression analysis identified placement of subgaleal drain following cranioplasty as a protective factor against the development of infection (OR: 0.16, p = 0.007). On average, drains remained in for 3 days, with no difference between the length of drains for those with infection vs. those without (p = 0.757).

Conclusions: The current study demonstrates an infection rate of 7.9% in patients who receive an autologous cranioplasty following decompressive craniectomy, which is consistent with previous data. Half (4%) of patients who experienced an infection ultimately required removal of the implant. While it is common practice for neurosurgeons to use drains to prevent hematomas and fluid collections, we found that subgaleal drain placement following cranioplasty was associated with decreased infection, thus demonstrating another benefit of a commonly used tool.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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