Chen Bo, Li Wenchen, Chen Dawei, Fu Shuanglin, Gao Yanli, Li Ri, Meng Fanyang, Wang Haifeng, Zhang Shuyan
Neurotrauma & Neurosurgery Department of the First Hospital of Jilin University, Chang Chun, China.
Neurotumor & Neurosurgery Department of the First Hospital of Jilin University, Chang Chun, China.
J Clin Neurosci. 2017 Oct;44:196-202. doi: 10.1016/j.jocn.2017.06.060. Epub 2017 Jul 6.
Titanium mesh cranioplasty is routinely used worldwide for skull defect patients given its advantages, such as stability and biocompatibility. However, there are very few reports concerning the treatment of implant-associated scalp infection, which is one of the most common complications. The aim of the study is to retrospectively evaluate a novel operation technique for the treatment of titanium mesh-associated scalp infection post-cranioplasty, namely partial titanium mesh explantation (PTME). A retrospective study was conducted in all patients who underwent surgical treatment for implant-associated scalp infection from January 2012 to September 2016 in our hospital. In total, 17 patients were selected for study analysis among 231 patients who underwent cranioplasty. The treatment success rate of PTME was 85.7%. There was no statistically significant difference in demographics and characteristics except for follow-up length of time between the PTME group and TTME (total titanium mesh explantation) group (Non-paired Student's t-test, P=0.037). While, The PTME group exhibited a significantly reduced skull defect area post-operation compared with the TTME group (Non-paired Student's t-test, P=0.002). Moreover, post-PTME skull area also exhibited a significantly reduced skull defect area compared with the pre-cranioplasty area in the same patient (Non-paired Student's t-test, P=0.006). Compared with traditional surgical treatment of implant-associated scalp infection, PTME combined with strict debridement and antibiotic therapy can cure implant-associated scalp infection. Moreover, PTME could preserve sufficient titanium mesh for brain protection and cosmesis.
钛网颅骨成形术因其稳定性和生物相容性等优点，在全球范围内被常规用于颅骨缺损患者。然而，关于植入物相关头皮感染（最常见的并发症之一）治疗的报道却非常少。本研究的目的是回顾性评估一种治疗颅骨成形术后钛网相关头皮感染的新手术技术，即部分钛网取出术（PTME）。对2012年1月至2016年9月在我院接受植入物相关头皮感染手术治疗的所有患者进行了回顾性研究。在231例行颅骨成形术的患者中，共选取17例患者进行研究分析。PTME的治疗成功率为85.7%。PTME组与全钛网取出术（TTME）组在人口统计学和特征方面，除随访时间外，差异无统计学意义（非配对学生t检验，P = 0.037）。同时，与TTME组相比，PTME组术后颅骨缺损面积显著减小（非配对学生t检验，P = 0.002）。此外，同一患者PTME术后颅骨面积与颅骨成形术前相比，颅骨缺损面积也显著减小（非配对学生t检验，P = 0.006）。与传统的植入物相关头皮感染手术治疗相比，PTME联合严格的清创和抗生素治疗可以治愈植入物相关头皮感染。此外，PTME可以保留足够的钛网用于脑保护和美容。
