Effectiveness and Safety of Subcutaneous Abdominal Preservation of Autologous Bone Flap after Decompressive Craniectomy: A Prospective Pilot Study

Baldo, Sara; Tacconi, Leonello

doi:10.1016/j.wneu.2010.02.018

Cited by 45 publications

(20 citation statements)

References 17 publications

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“…Currently there is no standard method to handle the explanted craniectomy bone flaps. A traditional method is to place the bone flap in a subcutaneous pocket at the abdominal wall till retrieval for cranioplasty [8,9]. Alternatively, craniectomy bone flaps can be stored at a hospital Skull Bone Bank in a freezer at À80°C (with an acceptable range of À70°C to À90°C) [10] under aseptic technique.…”

Section: Introductionmentioning

confidence: 99%

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Chan

Mok

Lam

et al. 2017

Journal of Clinical Neuroscience

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Craniectomy is a life-saving procedure. Subsequent cranioplasty with autologous skull bone has a bone resorption rate from 4% to 22.8% and an infection rate from 3.3% to 26%. There are concerns with their viability and the potential microbial contamination as they were explanted for a long period of time. Eighteen cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the period from June 2011 to March 2016 were identified. Ethics approval was obtained. Bone chips and deep bone swabs were collected for osteoblast culture and microbial culture. Skull Bone Bank was kept at -80°C under strict aseptic technique during the study period. The storage period ranged from 4months to 55months. For the osteoblast culture, all eighteen bone flaps had no viable osteoblast growth. For the bacterial culture, five had positive bacteria growth (27.8%). Three were Pasteurella multocida and two were Methicillin-resistant Staphylococcus aureus. The mean duration of storage of the infected bone flap was 32.9months (±15.1months) versus 19.9months (±17.9months) of those bone flaps with no bacterial growth (p=0.1716). The mean size of the infected versus non-infected bone flaps was 117.7cm (±44.96cm) versus 76.8cm (±50.24cm) respectively (p=0.1318). Although in this study statistical significance was not reached, it was postulated that infected bone flaps tended to be larger in size and had a longer duration of storage. In conclusion, cryostored skull bone flaps beyond four months showed no viable osteoblasts. Bacterial contamination rate of bone flaps was 27.8% in this study.

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Section: Introductionmentioning

confidence: 99%

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Chan

Mok

Lam

et al. 2017

Journal of Clinical Neuroscience

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“…Even so there are other important clinical and logistical considerations during the acute decompressive surgery concerning the storage site for the cranial bone flap raised. Current practices include further invasive surgical dissections, in vivo , in various other parts of the same patient's anatomy either distant to the cranial window in sites like the thighs or the abdominal wall;[461023] or close by on the head, as a separate subgaleal pouch,[111921] or in situ over the cranial window. [121823] There are other choices for extracorporeal storage of the bone flaps.…”

Section: Discussionmentioning

confidence: 99%

Decompressive craniectomy bone flap hinged on the temporalis muscle: A new inexpensive use for an old neurosurgical technique

Adeleye¹,

Azeez²

2011

Surg Neurol Int

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Background:The neurosurgical procedure of hinge decompressive craniectomy (hDC), or hinge craniotomy (HC), as described from units in the advanced countries makes use of metallic implants, usually titanium plates and screws, which may not be economically viable in resource-limited practice settings.Methods:We describe our surgical techniques for performing this same procedure of hDC in a developing country using the patient's own temporalis muscle instead of any other potentially costly implants.Results:The technique as described appears to be successful in achieving intracranial decompression in cases of traumatic brain swelling in which it has been used. Clinical and radiological illustrations of the feasibility, and practical utility, of the procedures in four clinical scenarios of traumatic brain injury are presented. Like all other techniques of HC, this new surgical technique of hDC temporalis saves the survivors the added imperative of future cranioplasty of the usual postcraniectomy skull defect. Unlike the others, the procedure eliminates the added cost of the metallic implants needed to perform the former techniques.Conclusions:The procedure of hDC temporalis appears to be a viable option for performing the surgical procedure of HC and has added cost-cutting economic benefits for resource-limited practice settings.

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“…60,80,91,114 Additionally, there have been limited reported cases on the tendency of children to suffer aseptic resorption of sterilized bone flaps, which is hypothesized to be attributable to an array of possible causes, from inherent hyperactive cellular responses to the degree of calvarial thickness in this subpopulation. 41,45,51 Disillusionment with autologous bone cranioplasty continues to exist given the propensity for resorption (reported rates are as high at 50% across all age groups), 8,41,113 inadequate contouring, debate over optimal means of bone flap preservation, 5,50,83,95 and potential for donor-site morbidity; these in sum continue to limit the use of this biomaterial for a broader spectrum of patients. 15,120 allografts Sicard, Dambrin, and Roger introduced the use of cadaveric skull in cranioplasty during the latter half of the 1910s.…”

Section: Autograftsmentioning

confidence: 99%

Evolution of cranioplasty techniques in neurosurgery: historical review, pediatric considerations, and current trends

Feroze

Walmsley

Choudhri

et al. 2015

JNS

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Cranial bone repair is one of the oldest neurosurgical practices. Reconstructing the natural contours of the skull has challenged the ingenuity of surgeons from antiquity to the present day. Given the continuous improvement of neurosurgical and emergency care over the past century, more patients survive such head injuries, thus necessitating more than ever before a simple, safe, and durable means of correcting skull defects. In response, numerous techniques and materials have been devised as the art of cranioplasty has progressed. Although the goals of cranioplasty remain the same, the evolution of techniques and diversity of materials used serves as testimony to the complexity of this task. This paper highlights the evolution of these materials and techniques, with a particular focus on the implications for managing pediatric calvarial repair and emerging trends within the field.

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Effectiveness and Safety of Subcutaneous Abdominal Preservation of Autologous Bone Flap after Decompressive Craniectomy: A Prospective Pilot Study

Cited by 45 publications

References 17 publications

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Decompressive craniectomy bone flap hinged on the temporalis muscle: A new inexpensive use for an old neurosurgical technique

Evolution of cranioplasty techniques in neurosurgery: historical review, pediatric considerations, and current trends

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