Despite rare, large cranial infected defects involving dura mater are challenging for practicians. Many patients are poor candidates for immediate reconstruction because of original pathology, comorbidities or previous radiotherapy. Recently, few authors have reported the use of negative pressure wound therapy (NPWT) in association with a first-step debridement surgery with encouraging results (1-2). In our institution, when immediate reconstruction is not feasible, a standardized reproducible two-steps procedure has been established.
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