Low-Cost Wound Healing Protocol Reduces Infection and Reoperation Rates After Cranioplasty: A Retrospective Cohort
Ali I Rae1, Brannan E O'Neill1, Jamila Godil1
1Department of Neurological Surgery, Oregon Health & Science University, Portland , Oregon , USA.
Neurosurgery
|June 15, 2023
Summary
A wound healing protocol significantly reduced cranioplasty infections and reoperations. This low-cost intervention saved over $50,000 per 24 patients, demonstrating its value in improving patient outcomes.
Area of Science:
- Neurosurgery
- Surgical Outcomes
- Infection Control
Background:
- Cranioplasty infections are a frequent and costly complication.
- These infections lead to significant patient morbidity.
- Reducing infection rates is crucial for improving patient care and lowering healthcare expenses.
Purpose of the Study:
- To evaluate the effectiveness of a wound healing protocol in reducing cranioplasty infections.
- To assess the economic value of implementing this protocol.
- To determine if the intervention impacts reoperation rates.
Main Methods:
- Retrospective chart review of 359 cranioplasty patients over 12 years.
- Comparison of outcomes before and after instituting a wound healing protocol (vitamin/mineral/fluid supplementation, oxygen support).
- Analysis included surgical site infections, 30-day reoperations, and cranioplasty explants, along with cost data.
Main Results:
- The pre-protocol group had significantly higher odds of surgical site infection (OR 5.21).
- Risk of washout (HR 2.86) and cranioplasty flap explant (OR 4.70) were also higher before the protocol.
- No significant difference in 30-day reoperation rates was observed (OR 2.21).
Conclusions:
- A low-cost wound healing protocol effectively reduced cranioplasty infections.
- The protocol led to a decrease in reoperations for washout.
- The intervention resulted in significant cost savings for the healthcare system.
