Reduction of Surgical Site Infections After Cranioplasty With Perioperative Bundle

Background: Surgical site infections (SSI) are the most common complication after cranioplasty and it is associated with poor prognosis. The aim of this study was to identify the risk factors that triggered the development of SSI after cranioplasty and establish a new perioperative bundle and monitoring system to reduce SSI. Methods: A retrospective review of a database that included all cranioplasty patients from 2001 to 2007 was carried out to determine the prevalence of infection. A surveillance team was set up, which assessed the clinical practice and led to the development of a new perioperative bundle and supervision system. A prospective study between 2008 and 2014 was carried out to observe whether infection rates had changed and whether an active surveillance program can change clinical practice. Results: Retrospective period included 86 adult patients. The overall rate of infection was 10.5% (9 SSI in 86 patients). Age ≥60 years (OR 1.05; 95% CI: 1.00–1.10; P = 0.04), smoking (OR 9.13; 95% CI: 1.65–50.60; P = 0.01), and duration of operation ≥180 minutes (OR1.19; 95% CI: 1.06–1.34; P 

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