Does the use of particulate bone graft increase the incidence of postoperative infection in surgery for craniosynostosis?

Objective: The use of particulate bone graft (PBG) has become an accepted technique for filling cranial defects created during cranial vault expansion for craniosynostosis. However, the use of PBG may be a risk factor for postoperative infection. The aim of this study was to compare the rate of postoperative infection in patients who received particulate bone graft (PBG+) with that in patients who did not (PBG-). Design: An Institutional Review Board-approved, retrospective, cohort study of consecutive patients was performed. Twenty-seven consecutive patients in the PBG- group were compared with 21 consecutive patients in the PBG+group. The two cohorts were assessed for incidence of surgical-site infection. Results: Statistical analysis was performed using the Fisher exact probability test. Surgical site infection occurred in none of the PBG- patients (0%) versus one of the PBG+ patients (4.76%). This difference in infection rates between the two cohorts was not statistically significant (P = .4375). Conclusions: Although there may be concern that PBG could serve as a facilitative medium for bacterial growth, this study demonstrates no statistically significant increase in infection rates with its use. Particulate bone grafting of cranial defects resulting from cranial vault expansion in craniosynostosis remains a useful and valuable technique.