Abstract
BackgroundThe use of cranial fixation devices in neurosurgery is very common, which is considered to be an important auxiliary method for many craniotomies. However, previous studies have reported complications of using cranial fixation devices, including brain tissue, nerve and blood vessel damage, scalp laceration, subcutaneous hematoma, etc. Some of the complications are serious and even potentially fatal, and the causes of which may be related to the incorrect use of cranial fixation devices. Although there are no serious complications in our review, the cause of that needs to be further summarized and analyzed, as so to minimize the serious consequences caused by the cranial fixation device slippage and ensure the safety of the patients’ surgical procedure.Case presentationIn our recent work, we have continuously found three cases of unstable cranial fixation devices, which make us to analyze the possible factors and summarize experience combined with the review of other senior neurosurgeons (more than 3 years of working experience) from different departments of neurosurgery.ConclusionsBased on our recent incidents of unstable cranial fixation and the experience of investigating and analyzing senior doctors from different neurosurgery centers, we summarized experience to minimize the risk of unstable cranial fixation. We tried a variety of options, including a safe anatomical location for cranial fixation, teamwork, and communication with anesthesiologists and itinerant nurses, to ensure the stability of the patient’s cranial fixation devices. The data obtained in this survey has great limitations, including the doctor’s personal prejudice and dependence on anecdotal memories. Therefore, the data should be interpreted with caution. However, there are still some modes that can help to better understand the use of safe cranial fixation. Based on the above research and analysis, we have made recommendations that may help neurosurgeons to avoid preventable complications
Highlights
The use of cranial fixation devices in neurosurgery is very common, which is considered to be an important auxiliary method for many craniotomies
We have continuously found three cases of unstable cranial fixation devices, which reminded us to analyze the possible factors and summarize experience combined with the review of other senior neurosurgeons from different departments of neurosurgery
There is no complete slip of head frame and serious complications, and the main results are partially displacement of cranial fixation devices and reduction of pressure
Summary
The data obtained in this survey has great limitations, including the doctor’s personal prejudice and dependence on anecdotal memories. The data should be interpreted with caution. Despite these limitations, there are still some modes that can help to better understand the use of safe cranial fixation. The following suggestions are based on the survey responses and our own practical experience Follow the process to install cranial fixation devices, and at least two doctors are present to verify the stability of cranial fixation devices. The junior doctors need to install the head frame with the assistance of the senior doctors, and gradually accumulate experience; 2. In patients with a heavier head and thicker scalp, we should increase the pressure appropriately to ensure the stability of the cranial fixation devices; 3. The position of the cranial fixation devices needs to be carefully analyzed to ensure that the center of
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