RT Journal Article
T1 Reduction in the infection rate of cranioplasty with a tailored antibiotic prophylaxis: a nonrandomized study
A1 Paredes Sansinenea, Igor
A1 Lagares Gómez-Abascal, Alfonso
A1 San Juan Garrido, Rafael
A1 Gómez López, Pedro Antonio
A1 Jiménez Roldán, Luis
A1 Pérez Núñez, Ángel
A1 Fernández Alén, José Antonio
AB BackgroundCranioplasty carries a high risk of surgical site infections (SSIs) for a scheduled procedure, particularly with antibiotic-resistant bacteria.MethodsThe goal of this retrospective study was to measure the effect of tailored antibiotic prophylaxis on SSIs resulting from cranioplasties. The authors collected a prospective database of cranioplasties from 2009 to 2018. Risk factors for SSI were registered, as well as infection occurring during the first year postoperatively. A new protocol was initiated in 2016 consisting of antibiotic prophylaxis tailored to the colonizing flora of the skin of the scalp and decolonization of patients who were nasal carriers of methicillin-resistant S. aureus (MRSA); infection rates were compared.ResultsOne hundred nine cranioplasties were identified, 64 in the old protocol and 45 in the new protocol. Of the 109 cranioplasties, 16 (14.7%) suffered an infection, 14 (21.9%) in the old protocol group and 2 (4.4%) in the new protocol group (OR for the new protocol 0.166, 95% CI 0.036–0.772). Multiple surgeries (OR 3.44), Barthel ≤ 70 (OR 3.53), and previous infection (OR 3.9) were risk factors for SSI. Of the bacteria identified in the skin of the scalp, 22.2% were resistant to routine prophylaxis (cefazoline). Only one patient was identified as a nasal carrier of MRSA and was decolonized.ConclusionsA high percentage of bacteria resistant to routine prophylaxis (cefazoline) was identified in the skin of these patients’ scalps. The use of tailored antibiotic prophylaxis reduced significantly the infection rate in this particular set of patients.
PB Springer Nature
SN 0001-6268
YR 2020
FD 2020-07-27
LK https://hdl.handle.net/20.500.14352/133451
UL https://hdl.handle.net/20.500.14352/133451
LA eng
NO Paredes I, Lagares A, San-Juan R, Castaño-León AM, Gómez PA, Jimenez-Roldán L, Panero I, Eiriz C, García-Perez D, Moreno LM, Perez-Nuñez A, Gonzalez-León P, Alén JAF. Reduction in the infection rate of cranioplasty with a tailored antibiotic prophylaxis: a nonrandomized study. Acta Neurochir (Wien). 2020 Nov;162(11):2857-2866.
NO Instituto de Salud Carlos III
NO Ministerio de Economía y Competitividad (España)
NO Unión Europea
DS Docta Complutense
RD 19 mar 2026