Does Difference in the Storage Method of Bone Flaps After Decompressive Craniectomy Affect the Incidence of Surgical Site Infection After Cranioplasty? Comparison Between Subcutaneous Pocket and Cryopreservation
- 1 January 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Trauma-Injury Infection and Critical Care
- Vol. 68 (1), 183-187
- https://doi.org/10.1097/ta.0b013e3181c45384
Abstract
After decompressive craniectomy for brain swelling, bone flaps need to be stored in a sterile fashion until cranioplasty. Temporary placement in a subcutaneous pocket (SP) and cryopreservation (CP) are the two commonly used methods for preserving bone flaps. Surgical site infection (SSI) is a serious complication of cranioplasty, and the storage method associated with a lower SSI incidence is favored. It is unclear, however, whether one storage method is superior to the other in terms of SSI prevention.During a 9-year period, 70 patients underwent decompressive craniectomy and subsequent cranioplasty. Bone flaps from 39 patients were stored using SP and those from the other 31 were stored using CP. Demographic data and SSI incidence was compared.There were no significant demographic differences between the groups. SSI occurred in seven patients: 2 (5.1%) in the SP group and 5 (16.1%) in the CP group. The difference was not statistically significant (p = 0.23). When each group was further divided into two categories based on etiology (traumatic brain injury [TBI] versus non-TBI), CP showed a significantly higher SSI incidence compared with SP (28.6% versus 0%, p = 0.02) in the TBI category. However, the difference in incidence was not significant in the non-TBI category.SP and CP may be equally efficacious for storage of bone flaps of non-TBI etiology; however, SP may be the storage method of choice for TBI. It remains to be verified in a prospective fashion whether SP is truly the better method of storing bone flaps in TBI.Keywords
This publication has 12 references indexed in Scilit:
- Factors affecting graft infection after cranioplastyJournal of Clinical Neuroscience, 2008
- Outcome After Decompressive Craniectomy for the Treatment of Severe Traumatic Brain InjuryJournal Of Trauma-Injury Infection and Critical Care, 2008
- Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical CenterCell and Tissue Banking, 2007
- Analyses of the factors influencing bone graft infection after delayed cranioplastyActa Neurochirurgica, 2006
- Cranioplasty with Subcutaneously Preserved Autologous Bone GraftsPlastic and Reconstructive Surgery, 2006
- Ethylene oxide sterilization of autologous bone flaps following decompressive craniectomyActa Neurochirurgica, 2003
- The Use of Frozen Autogenous Bone Flaps in Delayed Cranioplasty RevisitedNeurosurgery, 2003
- Cranioplasty: why throw the bone flap out?British Journal Of Neurosurgery, 2001
- Cranioplasty with a frozen and autoclaved bone flapActa Neurochirurgica, 1990
- Autogenous Skull CranioplastyNeurosurgery, 1979