SURGICAL SITE INFECTION OF ELECTIVE CRANIOTOMIES IN A MEDICAL RESIDENCY SERVICE IN NEUROSURGERY

Abstract

Surgical site infections of craniotomies, according to the Centers for Disease Control and Prevention of the United States, are defined as one of the following criteria: a) purulent drainage from a surgical incision; b) organism identification by culture; c) incision that dehisces, localized pain, localized inflammation, and/or fever (> 38 ºC); and evidence of empyema or abscess on images. The incidence of infection described by the literature varies from 2.2 to 19.8%. Objective: Verify the incidence of surgical site infections of nonemergent craniotomies in a medical residency service in neurosurgery. Methods: Retrospective study of the medical records of the patients submitted to nonemergent craniotomies between March 2018 and September 2019, and presented surgical site infection. Results: Out of 100 patients, the diagnosis of surgical site infection was established in 8 (8.0%). The mean duration of the surgical operations was 6.44 hours (2.25 to 10.75 hours). Clinical manifestations were incisional (n = 4; 50.0%), meningitis (n = 2; 25.0%), ostemyelitis (n = 1; 12.5%) and epidural empyema (n = 1; 12.5%). The treatment constituted of surgical reoperation and antibiotic therapy (n = 2; 25.0%) or only antibiotic therapy (n = 6; 75.0%). The antibiotic therapy lasted from 6 to 183 days (mean of 38.1 days). Microbiology revealed the infectious agent in two cases (n = 2; 25.0%). Conclusion: The incidence of surgical site infection of nonemergent craniotomies was congruent with the incidence described by the literature. Unequivocal risk factors for infection were not demonstrated by the study.