Complications of cranioplasty using a bone flap sterilised by autoclaving following decompressive craniectomy

Mraček, Jan; Hommerova, Jolana; Mork, Jan; Richtr, Patrik; Přibáň, Vladimír

doi:10.1007/s00701-014-2333-0

Cited by 47 publications

(29 citation statements)

References 41 publications

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“…In previous studies, the reported rate of SSI varies between 0% and 25.9% with an average of 7.7% 20). In our study, the overall infection rate was 7.9%, which is comparable with other studied.…”

Section: Discussionsupporting

confidence: 88%

“…CP is a commonly performed operation in the field of neurosurgery, however, it has a higher complication rate than other types of elective craniotomy 20). According to recent studies, the rates of complications after CP ranged from 16.4% to 34%, and varied according to the type of procedure and materials used 2357929).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Osawa et al21) demonstrated that frozen bone showed similar microscopic features to normal fresh bone, whereas osteocytes were destroyed in autoclaved bone. However, Mracek et al20) demonstrated that preservation technique by boiling, autoclaving and storing of a bone flap in a refrigerator at 8℃ could be a suitable alternative method and relatively successful outcome for CP have been obtained for 40 years using this technique. Kim et al14) recently reported a preservation technique that involved drying the autologous bone flap at 110℃ to 120℃ for 24 to 48 hours, sterilization at 70℃ for 75 minutes, storing the flap aseptically at room temperature, and then sterilizing at 70℃ for 75 minutes 1 to 2 days before the planned CP.…”

Section: Discussionmentioning

confidence: 99%

“…Mracek et al20) suggested that firm fixation of the bone flap seem to be important factors in the risk of BFR. They found the fixation of the bone flap by sutures (which is less rigid than when fixing the flap using miniplates) resulted in a trend towards a higher rate of BFR, but, it was not statistically significant in the current study ( p =0.16).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Kim

Kang

Cheong

et al. 2017

Korean J Neurotrauma

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ObjectiveThe aims of current study are to compare complications following cranioplasty (CP) using either sterilized autologous bone or polymethyl methacrylate (PMMA), and to identify the risk factors for two of the most common complications: bone flap resorption (BFR) and surgical site infection (SSI).MethodsBetween January 2004 and December 2013, 127 patients underwent CP and were followed at least 12 months. Variables, including sex, age, initial diagnosis, time interval between decompressive craniectomy (DC) and CP, operation time, size of bone flap, and presence of ventriculo-peritoneal shunt, were analyzed to identify the risk factors for BFR and SSI.ResultsA total of 97 (76.4%) patients underwent CP using PMMA (Group I) and 30 (23.6%) underwent CP using autologous bone (Group II). SSI occurred in 8 (8.2%) patients in Group I, and in 2 (6.7%) in Group II; there was no statistically significant difference between the groups (p=1.00). No statistically significant risk factors for SSI were found in either group. In Group I, there was no reported case of BFR. In Group II patients, BFR developed in 18 (60.0%) patients at the time of CP (Type 1 BFR), and at 12-month follow up (Type 2 BFR) in 4 (13.3%) patients. No statistically significant risk factors for BFR were found in Group II.ConclusionCP using sterilized autologous bone result in a significant rate of BFR. PMMA, however, is a safe alloplastic material for CP, as it has low complication rate.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Kim

Kang

Cheong

et al. 2017

Korean J Neurotrauma

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“…28 Autoclaved autologous bone reimplantation has a low rate of surgical site infection, but with a very significant rate of bone flap resorption. 29 However, long time span of cranioplasty can be risk factor for acute autologous bone flap infection. 30 The development of bone flap necrosis 31,32 and the Aseptic bone flap resorption is also a major concern in longterm follow-ups after cranioplasty.…”

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confidence: 99%

Cryopreservation Versus Intracorporeal Preservation of Cranial Bone Flaps; A Comprehensive Review of Literature

Khan

2017

TPMJ

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ABSTRACT:Cranioplasty is the surgical repair of a bone deformity of the skull. Autologous bone grafts are preferred more since the cranial bone flaps will not be subject to rejection by the host and they lower the entry of foreign materials into the body. Preservation of cranial bone flaps is done in numerous ways, namely cryopreservation after a decompressive craniectomy, intracorporeal preservation and cranioplasty with subcutaneously preserved autologous bone grafts. The method of preserving cranial bone flaps using cryopreservation has many advantages; it is a safe, simple and an effective method for autologous bone grafts. The cryopreservation is also associated with higher infection rates and bone resorption as complications when compared to intracorporeal preservation. Intracoporeal preservation technique has many advantages, particularly that this surgery is easy, safe and cost-effective. The duration of the operation is short. The autologous bone flaps are not subject to rejection and there is no need for intra-operative bone shaping. Therefore on the basis of review of literature authors concluded that intracorporeal preservation is better than cryopreservation of cranial bone flaps, in terms of efficacy and complications. Key words:Cranioplasty, Decompressive craniectomy, Cryopreservation, Intracorporeal preservation, Cranial bone flaps.

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Wound Management and Wound Infections in Neurosurgery

Schipmann

Molina

Schwake

et al. 2018

Recent Clinical Techniques, Results, and Research in Wounds

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Complications of cranioplasty using a bone flap sterilised by autoclaving following decompressive craniectomy

Cited by 47 publications

References 41 publications

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Comparison of Complications Following Cranioplasty Using a Sterilized Autologous Bone Flap or Polymethyl Methacrylate

Cryopreservation Versus Intracorporeal Preservation of Cranial Bone Flaps; A Comprehensive Review of Literature

Wound Management and Wound Infections in Neurosurgery

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