Evidence map›Paper›PMID 39472344›Full record

Observational studyActa neurochirurgica2024

Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration - an observational study.

Kathrin M Aufschnaiter-Hiessboeck, Harald Stefanits, Tobias Rossmann, Martin Aichholzer, Wolfgang Senker, Philip Rauch, Helga Wagner, Philipp Hermann, Matthias Gmeiner, Andreas Gruber and 1 more

Abstract readObservational Study
In one paragraph

Observational study in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kathrin M Aufschnaiter-HiessboeckDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Harald StefanitsDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria. harald.stefanits@kepleruniklinikum.at.
Tobias RossmannDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Martin AichholzerDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Wolfgang SenkerDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Philip RauchDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Helga WagnerCenter for Clinical Studies (CCS Linz), Johannes Kepler University Linz, Krankenhausstraße 5, 4020 Linz and Altenberger Strasse 69, Linz, 4040, Austria.
Philipp HermannCenter for Clinical Studies (CCS Linz), Johannes Kepler University Linz, Krankenhausstraße 5, 4020 Linz and Altenberger Strasse 69, Linz, 4040, Austria.
Matthias GmeinerDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Andreas GruberDepartment of Neurosurgery, Kepler University Hospital and Johannes Kepler University Linz, Wagner-Jauregg Weg 15, 4020 Linz and Altenbergerstrasse 69, Linz, 4040, Austria.
Manfred SchmidtPlastic and Reconstructive Surgery, Kepler University Hospital, Krankenhausstrasse 9, Linz, 4020, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesAlthough rare, complications like skin dehiscence and necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to the epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims to assess the prior clinical courses, neuroplastic repair, and outcomes of  patients with skin defects following cranial neurosurgical procedures, and to outline our interdisciplinary reconstructive protocol.

methodsA retrospective analysis was performed on cranial surgeries conducted at the Department of Neurosurgery,  spanning from 2017 to 2023. Patients with skin defects requiring the combined expertise of neurosurgery and plastic surgery for effective treatment were included. The sizes of the skin defects were measured using intraoperative photographs analyzed with the freeware ImageJ software, version 2018. All patients provided informed consent for the surgeries. If informed consent was not possible due to neurological deterioration, consent was sought from adult representatives or next of kin except for acute circumstances. All patients admitted to our hospital agree to the pseudonymized use of their medical data and tissue specimens for research purposes in their treatment contract.

resultsA cohort of 24 patients experiencing wound healing complications after neurosurgical procedures underwent a total of 29 interdisciplinary surgeries for the reconstruction of skin, dural, and bone defects.  After the neuroplastic surgery, 8 out of 24 patients (33.3%) developed surgical complications, with 6 of these requiring revision surgeries due to persistent cranial infection.  In all cases,  permanent wound closure was successfully achieved following adherence to the proposed treatment algorithm.

conclusionsOur study underscores the necessity of an integrated neurosurgical and plastic surgical approach to effectively manage wound healing complications in a single stage surgery. Key interventions include differentiation between necrosis and gaping lesions, alongside precise management of neurosurgical issues like cerebrospinal fluid fistulas and hydrocephalus. Plastic surgical expertise in assessing the possibilities and limitations of both local and free flap surgeries is essential.

Indexed as

Neurosurgical ProceduresPlastic Surgery ProceduresPostoperative ComplicationsWound HealingAdolescentAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesSkullSurgical Wound DehiscenceYoung AdultFree flapNecrosisQuestion mark shaped incisionScalp reconstructionWound dehiscence

Identifiers

PMID39472344
PMCPMC11522051

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.