Incidence of surgical site infections in cerebrovascular surgery: a single-center cohort study

Surgical site infections (SSI) constitute a source of morbidity in neurosurgical patients. Few reports address incidence of SSIs in patients undergoing craniotomy for neurovascular diseases.

This study aims to determine incidence and characteristics of SSI with interval to diagnosis, severity, and type of pathogen after intracranial neurovascular surgery.

Data from consecutive patients undergoing intracranial neurovascular surgery between January 2013 and 2022 were retrospectively analyzed in our tertiary referral center. Demographic data, risk factors, treatment and hospital stay were collected. Impact of SSI were classified according to Clavien Dindo Grade (CDG). Parameters studied included the time from index to revision surgery, microorganisms involved, and underlying pathology for the index surgery.

Among 1065 neurovascular surgeries, SSI occurred in 34 cases (2.1 %, n = 19 males). Median patient's age was 53 years (interquartile range, IQR 45-60). The median time from the index procedure to surgical wound revision was 27.5 days (IQR 19-44). The median length of hospital stay after revision surgery was 7 days (IQR 4-15). The predominant pathogen was Staphylococcus epidermidis (11, 32 %), followed by Staphylococcus aureus (8, 22 %). In 32 cases (89 %) wound revision was performed under general anesthesia.

The overall incidence of SSI in our center was 2.1 % with a mean time to wound revision of 29 days. These numbers can be used as a benchmark and reference for strategies that implement a reduction of postoperative infections in neurovascular surgery.