Effect of timing of ventriculo-peritoneal shunt and cranioplasty on postoperative complications after decompression of bone flap

Abstract

Objective To evaluate the effects of ventriculo-peritoneal (V-P) shunt and craniotomy of different timings on postoperative complications after decompression of bone flap. Methods The clinical data of 86 patients with bone flap decompression by V-P shunt and cranioplasty separately or simultaneously were collected and evaluated. The incidences of postoperative complications between simultaneous operation group and separate operation group were analyzed and compared. Binary multivariate Logistic regression analysis was used to assess the relative factors of postoperative complications. Results Craniocerebral injury (39/86, 45.3%) and spontaneous intracerebral hemorrhage (33/86, 38.4%) were the most common primary disease of hydrocephalus after skull defect, delayed healing or infection of the incision were the most common complications (13/86, 15.1%). The complication rate of patients in simultaneous operation group (55.2%) was significantly higher than that in separate operation group (18.8%, P<0.01), the incidence of postoperative infection in simultaneous operation group (28.9%) was significantly higher than that in separate operation group (4.2%, P=0.001). Multivariate Logistic regression analysis showed that operation time (OR=1.616, 95% CI: 1.026 -2.593, P=0.042) and flap tension (OR=2.164, 95% CI: 1.056-4.462, P=0.038) were significantly associated with the postoperative complications. Conclusions V-P shunt and cranioplasty can reduce postoperative complications in patients with hydrocephalus after decompression of bone flap. The separate operation is suitable for the patients with obvious swelling of the skin flap before operation. Key words: Decompression of bone flap; Ventriculo-peritoneal shunt; Cranioplasty