Cheng Yu-Kai, Weng Hsu-Huei, Yang Jen-Tsung, Lee Ming-Hsueh, Wang Ting-Chung, Chang Chen-Nen
Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan.
J Clin Neurosci. 2008 Oct;15(10):1115-9. doi: 10.1016/j.jocn.2007.09.022. Epub 2008 Jul 25.
The aim of this study was to identify the risk factors associated with bone grafts infection after cranioplasty. Eighty-four cranioplasties were performed on 75 patients between 2002 and 2006. Cryopreserved bone grafts were used as graft material in group 1 and polymethylmethacrylate (PMMA) was used in group 2. Risk factors including age, gender, time intervals between craniectomy and cranioplasty, mechanism of injury, number of procedures, graft material, and the Glasgow Coma Scale score were compared between groups. Swab culture results and bone graft infection were assessed in group 1. Multiple procedures before cranioplasty and an inadequate time interval between craniectomy and cranioplasty increase the risk of infection after cranioplasty. Swab culture results, age, gender, mechanism of injury, graft material and Glasgow Coma Scale score are not related to infection. The use of PMMA was associated with a relatively low risk of infection (6.25%). Risk of graft infection was not associated with the choice of graft material in the present study. Multiple procedures and insufficient time intervals increase the risk of infection. Interrupting the wound healing process may be the cause of infection. PMMA is a safe material for cranioplasty regardless of previous infection.
本研究的目的是确定颅骨成形术后与骨移植感染相关的危险因素。2002年至2006年间，对75例患者实施了84次颅骨成形术。第1组使用冷冻保存的骨移植作为移植材料，第2组使用聚甲基丙烯酸甲酯（PMMA）。比较两组之间的危险因素，包括年龄、性别、颅骨切除与颅骨成形之间的时间间隔、损伤机制、手术次数、移植材料以及格拉斯哥昏迷量表评分。对第1组进行拭子培养结果和骨移植感染评估。颅骨成形术前的多次手术以及颅骨切除与颅骨成形之间的时间间隔不足会增加颅骨成形术后的感染风险。拭子培养结果、年龄、性别、损伤机制、移植材料和格拉斯哥昏迷量表评分与感染无关。使用PMMA的感染风险相对较低（6.25%）。在本研究中，移植感染风险与移植材料的选择无关。多次手术和时间间隔不足会增加感染风险。伤口愈合过程中断可能是感染的原因。无论先前是否感染，PMMA都是颅骨成形术的安全材料。
