Can Skull Preservation Lead to Infection from Own Acne Bacteria?

Q: Can Skull Preservation Lead to Infection from Own Acne Bacteria?

Hello： There is a possibility of infection associated with the skull, whether it is removed, replaced, or retained in any state. <br>The original skull will be carefully evaluated by the physician to determine if it has been infected and whether it is appropriate to retrieve it.

Can the skull preservation be infected by its own acne bacteria?

Last month, my spouse underwent a craniotomy for the excision of an arteriovenous malformation, and the skull bone was temporarily stored for over a month.
During the second surgery these past few days, we inquired with the physician about the possibility of reattaching the skull bone, but we were informed that it had been infected by her own acne bacteria and may require reconstruction instead.
Could you please explain if such a situation can occur with skull bone preservation? Additionally, if the bone were to be reattached, what complications might arise? I am concerned that improper handling during preservation may have led to the infection.

Mr. Zheng, 50~59 year old female. Ask Date: 2022/05/25

Dr. Zhao Shaoqing reply Neurosurgery

Hello: There is a possibility of infection associated with the skull, whether it is removed, replaced, or retained in any state.
The original skull will be carefully evaluated by the physician to determine if it has been infected and whether it is appropriate to retrieve it.
If it is hastily returned, there may be a risk of wound infection and even meningitis.
It is recommended that you discuss this with your attending physician.
Wishing you a speedy recovery! The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2022/05/25

More Info

Skull preservation, particularly in the context of surgical procedures such as craniotomy, is a complex process that can indeed lead to infections, including those caused by the patient's own skin flora, such as acne bacteria (Propionibacterium acnes). When the skull is temporarily removed and stored, it is crucial to maintain a sterile environment to prevent contamination.
1. Infection Risks During Skull Preservation: The risk of infection during the preservation of the skull can arise from several factors. The skin naturally harbors various bacteria, including acne bacteria. If the skull is not adequately sterilized before preservation or if it is exposed to non-sterile conditions during the storage period, these bacteria can proliferate and lead to an infection. Infections can occur if the bacteria enter the bloodstream or surrounding tissues, particularly if there are any breaks in the skin or if the preservation process is not conducted under sterile conditions.

2. Consequences of Infection: If the skull bone becomes infected with acne bacteria or any other pathogens, it can lead to osteomyelitis (infection of the bone) or other complications. Symptoms may include localized pain, swelling, fever, and in severe cases, systemic infection. If the infection is significant, it may necessitate additional surgical interventions, such as debridement (removal of infected tissue) or even reconstruction of the skull.

3. Reimplantation of the Skull: If the skull is reimplanted after being infected, there is a risk that the infection could persist or worsen. The presence of bacteria can lead to complications such as abscess formation or chronic infection, which may require further surgical intervention. Surgeons typically assess the condition of the bone and surrounding tissues before proceeding with reimplantation to minimize these risks.

4. Preventive Measures: To mitigate the risk of infection during skull preservation, strict aseptic techniques must be employed. This includes thorough cleaning and sterilization of the skull before storage, as well as ensuring that the storage environment is sterile. Additionally, monitoring for any signs of infection during the preservation period is crucial.

5. Conclusion: In summary, while skull preservation can lead to infections from the patient's own acne bacteria, the risk can be minimized through proper surgical techniques and sterile handling. If there are concerns about the preservation process or the condition of the skull, it is essential to discuss these with the surgical team. They can provide guidance on the best course of action, whether that involves further treatment, monitoring, or alternative strategies for skull reconstruction.
In any case, it is vital to maintain open communication with healthcare providers regarding any concerns about infections or complications following surgical procedures. They can offer tailored advice based on the specific circumstances and medical history of the patient.

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