Case Report: Debridement with vacuum sealing drainage for conservative management of post-cranioplasty surgical site infection.

Post-cranioplasty infection represents a challenging complication in neurosurgical practice. Conventional therapeutic strategies typically necessitate implant removal or decompressive craniectomy, often resulting in secondary trauma and increased healthcare burden. We report a 55-year-old male patient who underwent decompressive craniectomy following traumatic brain injury and subsequently received cranioplasty with polyetheretherketone (PEEK) material. Four months postoperatively, he presented with wound dehiscence and purulent discharge, and was diagnosed with combined intracranial and scalp infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Following rigorous patient selection, two sessions of precise debridement were performed, combined with vacuum sealing drainage (VSD) therapy and individualized antimicrobial regimen based on susceptibility testing, with the PEEK implant preserved throughout. The infection was rapidly controlled, the VSD device was removed on postoperative day 6 with favorable wound healing, and no recurrence was observed at 3-month follow-up. Neurological function was fully restored with a modified Rankin Scale score of 0. This case demonstrates that for patients with post-cranioplasty infection involving PEEK material, a comprehensive approach incorporating debridement, VSD drainage, and targeted antimicrobial therapy-following strict evaluation-can achieve optimal outcomes with implant retention, offering a conservative treatment paradigm for such complex cases.