{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:40:27Z","timestamp":1792809627185,"version":"4.5.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors sought to evaluate the contemporary management of pediatric open skull fractures and assess the impact of variations in antibiotic and operative management on the incidence of infectious complications.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The records of children who presented from 2009 to 2017 to 6 pediatric trauma centers with an open calvarial skull fracture were reviewed. Data collected included mechanism and anatomical site of injury; presence and depth of fracture depression; antibiotic choice, route, and duration; operative management; and infectious complications.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of the fractures among the 138 patients included in the study, 48.6% were frontal and 80.4% were depressed; 58.7% of patients underwent fragment elevation. The average duration of intravenous antibiotics was 4.6 (range 0\u201321) days. Only 53 patients (38.4%) received a single intravenous antibiotic for fewer than 4 days. and 56 (40.6%) received oral antibiotics for an average of 7.3 (range 1\u201320) days. Wounds were managed exclusively in the emergency department in 28.3% of patients. Two children had infectious complications, including a late-presenting hardware infection and a superficial wound infection. There were no cases of meningitis or intracranial abscess. Neither antibiotic spectrum or duration nor bedside irrigation was associated with the development of infection.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The incidence of infectious complications in this population of children with open skull fractures was low and was not associated with the antibiotic strategy or site of wound care. Most minimally contaminated open skull fractures are probably best managed with a short duration of a single antibiotic, and emergency department closure is appropriate unless there is significant contamination or fragment elevation is necessary.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.10.peds20486","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T02:09:39Z","timestamp":1615514979000},"page":"533-537","source":"Crossref","is-referenced-by-count":5,"title":["Contemporary management of pediatric open skull fractures: a multicenter pediatric trauma center study"],"prefix":"10.3171","volume":"27","author":[{"given":"Cory","family":"McFall","sequence":"first","affiliation":[{"name":"Divisions of Pediatric Critical Care and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra D.","family":"Beier","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Wolfson Children\u2019s Hospital, Jacksonville;"},{"name":"University of Florida Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey","family":"Hayward","sequence":"additional","affiliation":[{"name":"University of Florida Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"Alberto","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children\u2019s National Medical Center, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randall S.","family":"Burd","sequence":"additional","affiliation":[{"name":"Division of Trauma and Burn Surgery, Department of General and Thoracic Surgery, Children\u2019s National Medical Center, Washington, DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany J.","family":"Farr","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P.","family":"Mooney","sequence":"additional","affiliation":[{"name":"Department of Surgery, Boston Children\u2019s Hospital, Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Gee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Children\u2019s Hospital of Los Angeles, Keck School of Medicine, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey S.","family":"Upperman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Children\u2019s Hospital of Los Angeles, Keck School of Medicine, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio A.","family":"Escobar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mary Bridge Children\u2019s Hospital, Tacoma, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole G.","family":"Coufal","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Critical Care and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen A.","family":"Harvey","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Critical Care and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Gollin","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, Rady Children\u2019s Hospital, San Diego, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"J Med Life","first-page":"234","article-title":"Traumatic brain injury in infants and toddlers, 0-3 years old","volume":"4","author":"Ciurea AV","year":"2011","unstructured":"Ciurea AV, Gorgan MR, Tascu A, . 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Cleve Clin J Med. 2017;84(9):673\u2013679."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/27\/5\/article-p533.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/27\/5\/article-p533.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/27\/5\/article-p533.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:08:00Z","timestamp":1792807680000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/27\/5\/article-p533.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":11,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2020.10.peds20486","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"value":"1933-0707","type":"print"},{"value":"1933-0715","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}