Evidence map›Paper›PMID 39569279›Full record

ArticleCureus2024

Polyetheretherketone (PEEK) Into the Future: Lowering Infection Rates in Cranioplasty.

Evan B Hughes, John Alfarone, Evan S Chernov, Nadia A Debick, Muhammad Jalal, Yeonsoo Kim, Amar Suryadevara, Satish Krishnamurthy

Erratum issuedAbstract read
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In one paragraph

Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Evan B HughesDepartment of Otolaryngology, Head and Neck Surgery, State University of New York Upstate Medical University, Syracuse, USA.
John AlfaroneDepartment of Otolaryngology, Head and Neck Surgery, State University of New York Upstate Medical University, Syracuse, USA.
Evan S ChernovDepartment of Otolaryngology, Head and Neck Surgery, State University of New York Upstate Medical University, Syracuse, USA.
Nadia A DebickDepartment of Otolaryngology, Head and Neck Surgery, State University of New York Upstate Medical University, Syracuse, USA.
Muhammad JalalDepartment of Neurosurgery, State University of New York Upstate Medical University, Syracuse, USA.
Yeonsoo KimDepartment of Neurosurgery, State University of New York Upstate Medical University, Syracuse, USA.
Amar SuryadevaraDepartment of Otolaryngology, Head and Neck Surgery, State University of New York Upstate Medical University, Syracuse, USA.
Satish KrishnamurthyDepartment of Neurosurgery, State University of New York Upstate Medical University, Syracuse, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSurgical site infection (SSI) is one of the most common complications following cranioplasty. At our institution, 3D printing has emerged as a popular option for creating customized polyetheretherketone (PEEK) cranioplasty implants that are lower profile than older, non-3D-printed implants. The 3D-printed implants can be integrated, with fixation plates already attached, or nonintegrated, with separate fixation plates available. To our knowledge, no study has analyzed the differences in infection rates between integrated and nonintegrated 3D-printed implants.

objectivesThis study aimed to explore whether integrated 3D-printed cranioplasty implants lead to decreased infection risk and improved patient outcomes compared to nonintegrated 3D-printed implants and further aims include exploring how operating room time and hospital length of stay affect infection risk.

methodsA retrospective chart review of 197 patients who underwent cranioplasty surgery from 2012 to 2023 was conducted. The postcranioplasty infection rate was compared between the integrated and nonintegrated 3D implants. Pre- and postoperative antibiotic use, operating time, hospital stay length, and patient comorbidities were also evaluated. Statistical analysis was conducted using SPSS version 28.0 (IBM Corp., Armonk, NY). Initial bivariate statistics were utilized where appropriate, and ultimately, a binary logistic regression model was employed.

resultsOur overall infection rate was 12.2%, higher than the national average of 7.89%. There was no significant association between the implant type and postcranioplasty infection. However, when controlling for the clinical and demographic covariates in our study, patients who had a Charlson comorbidity index (CCI) of 3-4 were 6.36 times as likely to experience a postcranioplasty infection when compared to their counterparts with a CCI of 0, OR of 6.36, 95% CI of 1.01-40.0, and a p value of 0.048. Additionally, with every one-year increase in age, the number of infections decreased by 0.955, with an OR of 0.955, 95% CI of 0.915-0.996, and a p value of 0.031.

conclusionsWhile there was no significant difference in SSI between the integrated and nonintegrated 3D-printed PEEK implants, elevated CCI and age were associated with a greater risk of infection. Our overall infection rate exceeds that reported in a recent large-scale review, which may be attributable to the higher average CCI typically observed in our tertiary care setting. Our findings illustrate that integrated and nonintegrated 3D implants offer viable and efficacious options for patients with cranial vault deformities requiring surgical repair.

Indexed as

cranial vault deformitycranioplastyimplantsurgerysurgical site infection

Identifiers

PMID39569279
PMCPMC11578605

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Registered trials

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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.