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Published on: August 16, 2019
Incidence of Surgical Site Infection Requiring Reoperation Following Awake Craniotomy
Sheikh Momin1, Zara Aayat Adil2, Erminia Albanese3
1Department of Neurosurgery, University Hospitals of North Midlands, Stoke-On-Trent, England, UK; Institute of Inflammation & Ageing, University of Birmingham, Birmingham, England, UK.
World Neurosurgery
|May 21, 2026
Summary
Awake craniotomy (AC) for brain tumors has a 4.6% surgical site infection requiring reoperation rate, similar to asleep craniotomies. Glioblastoma, redo surgery, and ventricular breach are associated risk factors for infection.
Area of Science:
- Neurosurgery
- Oncology
- Infectious Disease
Background:
- Awake craniotomy (AC) is crucial for resecting brain tumors near eloquent areas, preserving function.
- Minimizing surgical site infections (SSI) is vital to prevent delays in adjuvant therapy.
- Limited UK data exists on SSI requiring reoperation after AC.
Purpose of the Study:
- To determine the incidence of surgical site infections requiring reoperation (SSI-R) following AC in the UK.
- To compare SSI-R rates between AC and asleep craniotomies.
- To identify risk factors associated with SSI-R in AC.
Main Methods:
- Retrospective case series of 131 AC procedures (2015-2023).
- Data collected from electronic health records, including indications, demographics, and intra-operative details.
- SSI-R identified via theatre records, microbiology, and clinical notes; compared with asleep craniotomies.
Main Results:
- Six SSI-R cases (4.6%) occurred in 109 patients undergoing AC.
- Associated factors included glioblastoma (5/6), ventricular breach (4/6), and prior redo surgery (4/6).
- SSI-R rate (4.6%) was comparable to asleep craniotomies (3.0%), with no statistical significance (p=0.413).
Conclusions:
- The SSI-R rate following AC is 4.6%, comparable to asleep craniotomies.
- Glioblastoma, redo surgery, and ventricular breach are significant risk factors for SSI-R.
- Findings align with known risks for infection in cranial neurosurgery.
