Perioperative management and prevention of postoperative complications in patients undergoing cranioplasty with polyetheretherketone

Abstract

Objective: This study aimed to compare the incidence of postoperative complications in patients undergoing cranioplasty with polyetheretherketone (PEEK) materials under different perioperative management schemes and summarize and describe a perioperative bundle to reduce patients' postoperative complications and improve patient outcomes.

Method: We retrospectively analyzed the clinical data of 69 patients who had undergone craniotomy with PEEK materials in the neurosurgery department of our hospital between June 2017 and June 2021. Patients who had received conventional treatment were defined as the conventional group (29 cases), and those who had received the improved scheme were defined as the improved group (40 cases). The early complications of the two groups were compared, and the long-term effects were observed.

Results: The early total complication rates of the conventional and the improved groups were 55.2% and 32.5%, respectively, without any significant difference (P = 0.06), and the long-term complication rates were 24.1% and 7.5%, respectively, with no significant difference (P = 0.112). The incidence of epidural effusion in the improved group was significantly lower than that in the conventional group, with no significant difference in the incidence of complications, such as intracranial pneumatosis, epidural hemorrhage, new seizures and intracerebral hemorrhage. There was no difference in long-term complications, such as seizures, incision infections, and implant exposure.

Conclusion: Epidural effusion after cranioplasty with PEEK materials is common. This study's improved perioperative bundle can effectively reduce the occurrence of epidural effusion after skull repair.

Keywords: Complication; Cranioplasty; Epidural effusion; PEEK; Perioperative management.