Post-operative infections of osteoplastic compared with free bone flaps

A retrospective study was performed to evaluate the rate of infection in free and osteoplastic bone flaps after craniotomy. Two hundred and two craniotomies were performed in 98 cases of tumour, 35 cases of trauma and 69 cases of vascular disease. The overall incidence of infection was 6.4% (13 cases). The infectious agents were Staphylococcus aureus in four cases; Pneumococcus and gram-positive rods each in one case. In seven cases no infectious agent was identified. In 127 cases with free bone flaps eight (6.3%) were infected, and in 75 cases with osteoplastic bone flaps five (6.7%) were infected. One of five (20%) osteoplastic and four of eight (50%) free bone flaps had to be removed in order to accomplish healing, suggesting that an osteoplastic bone flap may be preserved more often in cases of infection.