Analyses of the factors influencing bone graft infection after delayed cranioplasty
Analyses of the factors influencing bone graft infection after delayed cranioplasty
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DOI：
10.1007/s00701-006-0740-6
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发表时间：
2006-05-01
影响因子：
2.4
通讯作者：
Nagashima, T
中科院分区：
文献类型：
--
作者：
Matsuno, A;Tanaka, H;Nagashima, T
背景分析影响颅骨修补术后植骨感染的几个因素，以减少感染的发生。自1995年3月至2005年2月，共施行延期颅骨修补术206例。个案包括一百二十四名男性及八十二名女性。患者年龄分布在6个月至79岁之间。平均术后随访时间为1834天。54例患者使用了自体骨，这些骨保存在-20 ℃的100%乙醇中，并在手术前进行高压灭菌。55例患者使用了聚甲基丙烯酸甲酯（PMMA）。3例患者使用定制PMMA。77例患者使用定制钛网。17例患者使用自制陶瓷（氧化铝陶瓷10例，羟基磷灰石7例）。高压灭菌和自体骨移植物和PMMA的移植物感染率明显较高。钛网的移植物感染率显著最低。氧化铝陶瓷的优点是具有足够的强度，但是使用包括氧化铝陶瓷在内的定制陶瓷的病例数量相对较少，因此与其他材料相比，我们无法发现感染率的显著差异。脑血管病、颅脑外伤、感染性疾病和脑肿瘤4类既往疾病的植骨感染率差异无统计学意义。高压灭菌和自体骨移植物和PMMA的移植物感染率显著较高。钛网的移植物感染率显著最低。
Background. Several factors influencing bone graft infection after delayed cranioplasty are analyzed in order to reduce the occurrence of infection.Methods. For about 10 years, from March 1995 to February 2005, delayed cranioplasty was performed for 206 cases. The cases comprised 124 males and 82 females. Age distribution of the patients ranged from 6 months to 79 years old. The mean postoperative follow-up period was 1834 days. Autogenous bone, which was preserved in 100% ethanol at -20 degrees C and autoclaved before operation, was used in 54 patients. Polymethylmethacrylate (PMMA) was used in 55 patients. Custom-made PMMA was used in 3 patients. Custom-made titanium mesh was used in 77 patients. Custom-made ceramics (Alumina-ceramics 10 cases and hydroxyapatite 7 cases) was used in 17 patients.Findings. Autoclaved and autogenous bone graft and PMMA have a significantly high rate of graft infection. Titanium mesh has the significantly lowest rate of graft infection. Alumina-ceramic has a merit that it has sufficient strength, however the number of cases using custom-made ceramics including alumina-ceramic was relatively small, and thus we cannot find significant differences in infection rate compared with that of other materials. There was no statistically significant difference in the bone graft infection rate among four categories of preceding diseases; cerebrovascular diseases, head trauma, infectious diseases, and brain tumour.Conclusion. Autoclaved and autogenous bone grafts and PMMA have a significantly higher rate of graft infection. Titanium mesh has the significantly lowest rate of graft infection.