Clinical Practice Changes Reduce Resorbable Plate-Associated Wound Complications in Cranial Vault Reconstructive...

Area of Science:

• Neurosurgery
• Pediatric Surgery
• Biomaterials Science

Background:

• Cranial vault reconstruction (CVR) surgery can lead to significant morbidity, with previous rates of wound complications and readmissions reported at 12.1% and 9.9% respectively, associated with resorbable PLGA plates.
• Clinical practice changes were implemented to mitigate these risks, focusing on preoperative sterilization, optimized surgical technique, and careful plate selection and placement.

Purpose of the Study:

• To evaluate the effectiveness of revised clinical practices in reducing resorbable plate-associated wound complications following cranial vault reconstruction.
• To determine if implemented changes lowered the incidence of wound complications requiring hospital readmission.

Main Methods:

• A retrospective comparative study analyzed patients before and after the introduction of new clinical practices.
• Statistical analysis, including t-tests and Mann-Whitney U tests, was used to compare patient demographics, operative details, and postoperative outcomes between the two cohorts.
• Data were analyzed using SPSS Version 28.

Main Results:

• The study included 75 patients who underwent surgery between 2018 and 2021, with a reduced complication rate of 5.3%.
• The proportion of patients requiring readmission significantly decreased to 4.0% post-implementation compared to the previous 12.1% (P=0.033).
• No significant differences were observed in gender, age, or weight between the patient cohorts.

Conclusions:

• The four revised clinical practices implemented in 2018 have significantly reduced wound complication rates requiring readmission in patients undergoing cranial vault reconstruction.
• These changes demonstrate a successful strategy for improving patient outcomes and reducing healthcare resource utilization post-CVR surgery.