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Management and prevention of cranioplasty infections

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Abstract

Background

Infection may complicate the outcome of cranial repair with significant additional morbidity, related to hospitalization, surgery and long antibiotic therapy, that may become even dramatic in case of multi-resistant germs and in particular in the paediatric population. Additionally, the economic costs for the health system are obvious. Moreover, surgical decisions concerning the timing of cranioplasty and choice of the material may be strongly affected by the risk of infection. Despite, management and prevention of cranioplasty infections are not systematically treated through the literature so far.

Methods

We reviewed pertinent literature dealing with cranioplasty infection starting from the diagnosis to treatment options, namely conservative versus surgical ones. Our institutional bundle, specific to the paediatric population, is also presented. This approach aims to significantly reduce the risk of infection in first-line cranioplasty and redo cranioplasty after previous infection.

Conclusions

A thorough knowledge and understanding of risk factors may lead to surgical strategies and bundles, aiming to reduce infectious complications of cranioplasty. Finally, innovation in materials used for cranial repair should also aim to enhance the antimicrobial properties of these inert materials.

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Authors and Affiliations

  1. Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Paolo Frassanito & Federico Bianchi

  2. Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Flavia Fraschetti & Massimo Caldarelli

  3. Infectious Diseases Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Francesca Giovannenze & Giancarlo Scoppettuolo

Authors
  1. Paolo Frassanito
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  2. Flavia Fraschetti
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  3. Federico Bianchi
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  4. Francesca Giovannenze
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  5. Massimo Caldarelli
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  6. Giancarlo Scoppettuolo
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Correspondence to Paolo Frassanito.

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Frassanito, P., Fraschetti, F., Bianchi, F. et al. Management and prevention of cranioplasty infections. Childs Nerv Syst 35, 1499–1506 (2019). https://doi.org/10.1007/s00381-019-04251-8

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