Role of negative pressure suction for depressed skull fractures in neonates

Abstract

Objective To explore the role of negative pressure for managing simple depressed skull fractures in neonates and review the relevant literatures. Methods Retrospective reviews were performed for medical records of 18 hospitalized neonates with depressed skull fractures from 1997 to 2017. They underwent spontaneous elevation (n=11) or negative pressure suction (n=7). Their admission age was from 2 hours to 25 days. And the depth of depression was from 0.3 to 1.3 cm. Results Among them, 16/18 were delivered via Cesarean section. One of two natural delivery was of dystocia. All fractures were located in parietal bone. Spontaneous restoration of depression was achieved in 11 patients within a period of 1 to 7 months. And reset time and depth of depression had a significant positive correlation (r=0.875, P 0.5 cm (n=6). Six cases recovered immediately without complications after vacuum extraction and only 1 case failed in one patient with the age of 25 days. All vacuum-extracted neonates had no such complication as intracranial hemorrhage or aggravation of existing hemorrhage. Conclusions With negative pressure aspiration, as long as indications and operative approaches are properly mastered, not only concave fracture may be reduced immediately, but also serious iatrogenic injury is avoided. The earlier negative pressure section is performed postnatally, the easier it can be reduced successfully. Key words: Cranium; Depressed fracture; Neonate; Treatment; Caesarean section; Negative pressure suction