Evidence map›Paper›PMID 42733610›Full record

ArticleJPRAS open2026

Material type versus defect size in adult cranioplasty: a multi-institutional analysis of 30-day outcomes and risk prediction modeling.

Jennifer A Watson, Julius M Wirtz, Victoria Kong, Samuel A Knoedler, Leonard Knoedler, Robert Gaudin, Herrmann F Sailer, Elisa Colombo, Schirin Rahiminia, Bahar Bassiri Gharb and 3 more

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Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

13 authors.

Jennifer A WatsonDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Julius M WirtzUCSF Medical Center, University of California San Francisco, San Francisco, CA, USA.
Victoria KongDivision of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Samuel A KnoedlerDivision of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
Leonard KnoedlerCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
Robert GaudinCharité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Oral and Maxillofacial Surgery, Berlin, Germany.
Herrmann F SailerDepartment of Oral and Maxillofacial Surgery, SailerClinic, Zurich, Switzerland.
Elisa ColomboDepartment of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Schirin RahiminiaDepartment of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Bahar Bassiri GharbDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Giuseppe EspositoDepartment of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.
Antonio RampazzoDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.
Filippo A G PerozzoDepartment of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The optimal cranioplasty material remains controversial in the context of defect size and patient risk. We analyzed multi-institutional data over 13 years to evaluate the interaction between material type and defect size. Methods: We performed a retrospective cohort analysis of adult cranioplasty patients in the ACS-NSQIP (2011-2023), stratifying by material type (autograft vs. alloplastic) and defect size (≤5 cm vs. >5 cm). The primary outcome was any 30-day complication. Multivariable logistic regression adjusting for 21 covariates, interaction analyses, and machine learning models were applied. Results: Among 3894 patients, 88% underwent autograft and 12% alloplastic cranioplasty. The 30-day complication rate was 22%, with no significant difference between material types ( Conclusion: Material type is not an independent predictor of short-term complications following cranioplasty, regardless of defect size or patient risk profile. Larger defects are associated with increased morbidity, but alloplastic materials offer significant operative efficiency without compromising short-term perioperative safety. Prospective studies with extended follow-up stratified by alloplastic subtype are needed.

Indexed as

Alloplastic materialsAutologous boneCranioplastyDefect sizePostoperative complicationsRisk prediction

Identifiers

PMID42733610
PMCPMC13571319

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