Cranioplasty Using Autoclaved Autologous Skull Bone Flaps Preserved at Ambient Temperature.

Abstract

Context:Decompressive craniectomy followed by cranioplasty (CP) uses autologous craniectomy flaps or synthetic materials like titanium. Sterilization and preservation methods for the autologous bone flaps continue to be the surgeon's choice.Aim:This study aimed to assess the short-term as well as long-term clinical outcomes of CP using autoclaved autologous bone grafts.Settings and Design:This retrospective observational study was performed on patients admitted in a tertiary care teaching neurosurgery department.Patients and Methods:Seventy-two patients who underwent CP with autoclaved autologous skull flaps preserved under ambient conditions with strict aseptic precautions were included in the study.Statistical Analysis Used:Frequencies and percentages of the various characteristics before and after the surgery were tabulated. Continuous variables were summarized as means and standard deviations.Results:The primary CP had a satisfactory clinical outcome in 62 cases (86.11%). Osteomyelitis was observed in four patients (5.56%) nearly 2 months after the surgery. Radiologically significant bone resorption was noted in a single patient (1.39%) after 1 year. Five patients (6.94%) developed bone fragmentation or fracture, and the mean time taken for this was about 36 months. In all these ten cases, secondary CP was successfully done using a prefabricated, patient-specific titanium mesh.Conclusions:The efficacy and safety of the studied craniectomy flaps used for cranial reconstruction showed a good patient outcome. Further retrospective studies with larger cohorts and prospective case–control studies are essential so as to issue standard guidelines for sterilization and preservation of autologous bone flaps.