Neurosurgery notes/Infection/Cranial infection/Post op wound infections

Post op wound infections

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Cranial infection

Laminectomy wound infection

  • 3% cases
  • Inc. risk
    • Obesity
    • Steroid
    • DM
    • Mild intraoperative hypothermia
  • Main: S aureus
  • Treatment
    • Vanc + 3rd gen cephalosporin (ceftazidime)
    • Surgical
      • Debride wound of all necrotic and devascularized tissue and any visible FB (suture material)
      • Shallow defects may allowed to heal by secondary intention
      • Ensure no tension in wound
      • If large defect present, Bone or dura exposed → use a muscle flap done by plastic surgeon
      • CSF leak requires exploration and water tight dural closure to prevent meningitis

Craniotomy infection

  • CRP peaks post op 2 with a mean of 40