Delayed Scalp Infection After Titanium Mesh Cranioplasty Managed With Implant Removal and Negative Pressure Wound Therapy

This case report describes a patient who sustained a traumatic brain injury in a motor vehicle accident and subsequently underwent titanium mesh cranioplasty. Postoperatively, the patient developed chronic scalp ulceration and infection. Over several years, recurrent infections persisted and ultimately progressed to a large-area scalp defect with extensive infection, caused by Staphylococcus aureus. The wide extent of the infected wound and poor local tissue condition significantly increased the complexity of surgical management and reconstruction. Two surgical procedures, including the complete removal of the titanium mesh and scalp reconstruction with skin grafting, combined with negative pressure wound therapy (NPWT), successfully controlled the infection and achieved satisfactory wound healing. This case highlights the potential risks associated with titanium mesh cranioplasty and emphasizes the importance of careful preoperative scalp evaluation and long-term postoperative follow-up. In patients with chronic scalp infection or implant exposure, especially those with extensive infected wounds and complex reconstructive requirements, timely surgical intervention involving implant removal and appropriate wound reconstruction is crucial for effective disease control.