There are No Differences between Factors Determining Graft Infection in Autologous Bone Flap Replacement and Acrylic Cranioplasty: A Prospective Observational Study at Hospital Kuala Lumpur

Objectives: This study, conducted in 2012, was performed to determine the incidence of graft infection after cranioplasty procedures and factors affecting the graft infection rate at Hospital Kuala Lumpur (HKL). Methodology: This was an observational cross-sectional case study of patients who have undergone cranioplasty at HKL over a period of one year (2012). One hundred seventy-two patients were included in the study. A total of 105 (61.8%) cases were autologous bone flap replacements, and 67 (38.2%) were acrylic cranioplasty. Result: A total of five infected grafts were identified among the 172 cases included in the study, resulting in an overall infection rate of 2.9%. Of this infected group, three (4.5%) were cases of cranioplasty and two (1.9%) were cases of autologous bone flap replacement. There was high proportion of male patients undergoing cranioplasty (118 [or 68.6%]) and only 54 (or 31.4%) female patients. The primary pathology in the majority of patients (126 [or 73.2%]) was due to trauma; only 46 cases (or 26.8%) did not result from trauma. Of the patients, 123 (or 71.5%) had undergone a single cranial procedure prior to their cranioplasty, and 43 (or 28.5%) had undergone multiple cranial procedures. Most of the patients (114 [or 66.3%]) underwent cranioplasty 90 days after undergoing decompressive craniectomy while 58 (or 33.7%) underwent cranioplasty less than 90 days after decompressive craniectomy.