Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Bacterial Contamination of Autologous Bone Flaps : Investigation and Targeted Antibiotic Treatment

Halling, Irina LU ; Silva, Maria João LU ; Ståhl, Nils LU ; Paulsson, Magnus LU orcid ; Al-Jammal, Muna LU ; Nittby Redebrandt, Henrietta LU ; Lood, Rolf LU and Holmberg, Anna (2026) In World Neurosurgery
Abstract

OBJECTIVE: Bacteria present on extracted bone flaps during decompressive craniectomy inhibit bone flap reimplantation. An adapted treatment with antibiotic mixture for decontamination of allografts could be used in neurosurgery for preparation of bone flaps for autologous cranioplasty.

METHODS: Eleven bone flaps were analysed using standardised bacterial cultures and droplet digital Polymerase Chain Reaction (ddPCR). Growth of Cutibacterium acnes, Staphylococcus aureus, and other Staphylococci species were detected. Bone flaps were treated with antibiotic mixtures for 24 hours before evaluating the antibacterial effect by measuring colony forming units (CFU) reduction.

RESULTS: Bacterial prevalence was in substantial... (More)

OBJECTIVE: Bacteria present on extracted bone flaps during decompressive craniectomy inhibit bone flap reimplantation. An adapted treatment with antibiotic mixture for decontamination of allografts could be used in neurosurgery for preparation of bone flaps for autologous cranioplasty.

METHODS: Eleven bone flaps were analysed using standardised bacterial cultures and droplet digital Polymerase Chain Reaction (ddPCR). Growth of Cutibacterium acnes, Staphylococcus aureus, and other Staphylococci species were detected. Bone flaps were treated with antibiotic mixtures for 24 hours before evaluating the antibacterial effect by measuring colony forming units (CFU) reduction.

RESULTS: Bacterial prevalence was in substantial agreement between standard culture methods and detection by ddPCR. Fragmentation of the bone revealed heterogeneous bacterial loads across fragments, consistent with the distribution of bacterial species commonly found in sample skin contamination. A 24-hour antibiotic treatment (mixture of gentamicin, vancomycin and cefotaxime) reduced the CFU of all detectable bacteria on the bone flaps.

CONCLUSION: Treatment of bone flaps with antibiotic mixture containing gentamicin, vancomycin and cefotaxime for 24 hours can effectively eradicate commonly identified bacteria, including Cutibacterium acnes and coagulase-negative Staphylococci from the bone tissue.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
World Neurosurgery
article number
125131
publisher
Elsevier
external identifiers
  • pmid:42303121
ISSN
1878-8750
DOI
10.1016/j.wneu.2026.125131
language
English
LU publication?
yes
additional info
Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.
id
4e456797-4f12-4f59-9402-fabc116012df
date added to LUP
2026-06-17 13:47:12
date last changed
2026-06-17 13:50:30
@article{4e456797-4f12-4f59-9402-fabc116012df,
  abstract     = {{<p>OBJECTIVE: Bacteria present on extracted bone flaps during decompressive craniectomy inhibit bone flap reimplantation. An adapted treatment with antibiotic mixture for decontamination of allografts could be used in neurosurgery for preparation of bone flaps for autologous cranioplasty.</p><p>METHODS: Eleven bone flaps were analysed using standardised bacterial cultures and droplet digital Polymerase Chain Reaction (ddPCR). Growth of Cutibacterium acnes, Staphylococcus aureus, and other Staphylococci species were detected. Bone flaps were treated with antibiotic mixtures for 24 hours before evaluating the antibacterial effect by measuring colony forming units (CFU) reduction.</p><p>RESULTS: Bacterial prevalence was in substantial agreement between standard culture methods and detection by ddPCR. Fragmentation of the bone revealed heterogeneous bacterial loads across fragments, consistent with the distribution of bacterial species commonly found in sample skin contamination. A 24-hour antibiotic treatment (mixture of gentamicin, vancomycin and cefotaxime) reduced the CFU of all detectable bacteria on the bone flaps.</p><p>CONCLUSION: Treatment of bone flaps with antibiotic mixture containing gentamicin, vancomycin and cefotaxime for 24 hours can effectively eradicate commonly identified bacteria, including Cutibacterium acnes and coagulase-negative Staphylococci from the bone tissue.</p>}},
  author       = {{Halling, Irina and Silva, Maria João and Ståhl, Nils and Paulsson, Magnus and Al-Jammal, Muna and Nittby Redebrandt, Henrietta and Lood, Rolf and Holmberg, Anna}},
  issn         = {{1878-8750}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Elsevier}},
  series       = {{World Neurosurgery}},
  title        = {{Bacterial Contamination of Autologous Bone Flaps : Investigation and Targeted Antibiotic Treatment}},
  url          = {{http://dx.doi.org/10.1016/j.wneu.2026.125131}},
  doi          = {{10.1016/j.wneu.2026.125131}},
  year         = {{2026}},
}