• World Neurosurg · Dec 2022

    Does plastic surgery involvement decrease complications after cranioplasty? A retrospective cohort study.

    • Robert J Dambrino, Jeffrey W Chen, Hani Chanbour, Rohan V Chitale, Peter J Morone, Reid C Thompson, and Scott L Zuckerman.
    • Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: rob.dambrino@vumc.org.
    • World Neurosurg. 2022 Dec 1; 168: e309e316e309-e316.

    ObjectivesTo compare postoperative outcomes after cranioplasties performed by neurosurgery only (N) versus neurosurgery and plastic surgery combined (N+P).MethodsA single-center, multisurgeon, retrospective cohort study was undertaken on all cranioplasties performed from November 2006 to December 2021. The primary exposure variable was operating team (N vs. N+P). The primary outcome was the need for reoperation. Secondary outcomes included surgical site infections, complications, length of stay (LOS), and length of drain placement.ResultsOf 188 patients undergoing cranioplasty during the study period, 106 (56%) patients were in the N group, and 82 (44%) were in the N+P group. Patient demographics were similar between the 2 groups. For the primary outcome, a total of 20 (18.9%) reoperations were seen in the N group, and 13 (15.9%) in the N+P group (P = 0.708). However, the median time to reoperation was slightly longer in the N+P group in the survival analysis. Wound dehiscence (1.9% vs. 3.7%, P = 0.454), surgical site infection (5.7% vs. 9.8%, P = 0.289), and complication rate (30.2% vs. 32.9%, P = 0.688) did not differ between the 2 groups. Furthermore, the N group had less Jackson-Pratt drain use (58.5% vs. 85.4%, P < 0.001), earlier drain removal (1.9 ± 1.6 vs. 3.4 ± 3.9 days, P < 0.001), and shorter LOS (3.8 ± 5.9 vs. 4.7 ± 3.9 days, P < 0.001). On multivariate regression analysis controlling for age, body mass index, smoking, craniectomy type, reason for craniectomy, and graft type, N+P was associated with increased drain use (odds ratio = 4.90, 95% confidence interval 2.28-11.30, P < 0.001) and longer drain duration (β = 1.50, 95% confidence interval 0.43-2.60, P = 0.007).ConclusionsDespite similar complication and reoperation rates between groups, reoperations in the N group occurred sooner, whereas the N+P group more commonly used drains and kept drains in for longer.Copyright © 2022 Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.