Predictive Value of Swab Cultures for Cryopreserved Flaps During Delayed Cranioplasties

■ OBJECTIVE: To assess the predictive value of swab cultures of cryopreserved skull flaps during cranioplasties for surgical site infections (SSIs). ■ METHODS: A retrospective review was conducted of consecutive patients who underwent delayed cranioplasties with cryopreserved autografts between 2009 and 2017. The results of cultures obtained from swabs and infected sur-gical sites were assessed. The accuracy, sensitivity, and specificity of swab cultures for SSIs were evaluated. ■ RESULTS: The study included 422 patients categorized into two groups, swab and nonswab, depending on whether swab cultures were implemented during cranio-plasties. The overall infection rate was 7.58%. No differ-ence was seen in infection rates between groups. There were 18 false-positive and no true-positive swab culture results. All bacteria between swab cultures and SSI cultures were discordant. Meanwhile, there were 19 false-negative swab cultures. The results showed high speci-ficity but low sensitivity for swab cultures to predict SSI occurrence and the pathogens. ■ CONCLUSIONS: Owing to low accuracy and sensitivity, swab cultures of cryopreserved autografts should not be routinely performed during delayed cranioplasties.