Multi-stage Preparation for the Repair of Complicated Skull Defects

Yoshiaki Sakamoto, Eric Arnaud

Research output: Contribution to journalArticle

Abstract

Cranioplasty following decompressive craniectomy is highly associated with complications. Methods for avoiding these complications have been well-documented; however, approaching reconstruction through the previous incision, especially if it was on or very near the bone defect, can sometimes lead to wound dehiscence and infection, with exposure of the artificial bone. For such complicated cases, we propose a multi-staged preparation that includes creating a delayed skin flap for the actual skull reconstruction. Flap was elevated in three stages, with 4 week intervals between each stage to allow for adequate blood supply. Cranioplasty using custom-made implants was then performed. Four patients (age range, 10-25 years) were prepared for skull reconstruction using this technique. During follow-up period for 12 months, no complications, including infections, exposure of the artificial bone, or flap necrosis, were observed. Despite the multiple stages required, we consider that our technique makes a significant contribution to the literature because it suggests a technique for cranioplasty following decompressive craniectomy that may avoid many of the complications following such cranioplasty using current methods.

Original languageEnglish
Pages (from-to)172-175
Number of pages4
JournalNeurologia medico-chirurgica
Volume59
Issue number5
DOIs
Publication statusPublished - 2019 May 15

Fingerprint

Decompressive Craniectomy
Skull
Bone and Bones
Wound Infection
Necrosis
Skin
Infection

Keywords

  • cranial defect
  • cranial reconstruction
  • cranioplasty
  • delayed phenomenon

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Multi-stage Preparation for the Repair of Complicated Skull Defects. / Sakamoto, Yoshiaki; Arnaud, Eric.

In: Neurologia medico-chirurgica, Vol. 59, No. 5, 15.05.2019, p. 172-175.

Research output: Contribution to journalArticle

@article{a1f0cda05e2b4b8094ff6902cd59cc79,
title = "Multi-stage Preparation for the Repair of Complicated Skull Defects",
abstract = "Cranioplasty following decompressive craniectomy is highly associated with complications. Methods for avoiding these complications have been well-documented; however, approaching reconstruction through the previous incision, especially if it was on or very near the bone defect, can sometimes lead to wound dehiscence and infection, with exposure of the artificial bone. For such complicated cases, we propose a multi-staged preparation that includes creating a delayed skin flap for the actual skull reconstruction. Flap was elevated in three stages, with 4 week intervals between each stage to allow for adequate blood supply. Cranioplasty using custom-made implants was then performed. Four patients (age range, 10-25 years) were prepared for skull reconstruction using this technique. During follow-up period for 12 months, no complications, including infections, exposure of the artificial bone, or flap necrosis, were observed. Despite the multiple stages required, we consider that our technique makes a significant contribution to the literature because it suggests a technique for cranioplasty following decompressive craniectomy that may avoid many of the complications following such cranioplasty using current methods.",
keywords = "cranial defect, cranial reconstruction, cranioplasty, delayed phenomenon",
author = "Yoshiaki Sakamoto and Eric Arnaud",
year = "2019",
month = "5",
day = "15",
doi = "10.2176/nmc.oa.2018-0283",
language = "English",
volume = "59",
pages = "172--175",
journal = "Neurologia Medico-Chirurgica",
issn = "0470-8105",
publisher = "Japan Neurosurgical Society",
number = "5",

}

TY - JOUR

T1 - Multi-stage Preparation for the Repair of Complicated Skull Defects

AU - Sakamoto, Yoshiaki

AU - Arnaud, Eric

PY - 2019/5/15

Y1 - 2019/5/15

N2 - Cranioplasty following decompressive craniectomy is highly associated with complications. Methods for avoiding these complications have been well-documented; however, approaching reconstruction through the previous incision, especially if it was on or very near the bone defect, can sometimes lead to wound dehiscence and infection, with exposure of the artificial bone. For such complicated cases, we propose a multi-staged preparation that includes creating a delayed skin flap for the actual skull reconstruction. Flap was elevated in three stages, with 4 week intervals between each stage to allow for adequate blood supply. Cranioplasty using custom-made implants was then performed. Four patients (age range, 10-25 years) were prepared for skull reconstruction using this technique. During follow-up period for 12 months, no complications, including infections, exposure of the artificial bone, or flap necrosis, were observed. Despite the multiple stages required, we consider that our technique makes a significant contribution to the literature because it suggests a technique for cranioplasty following decompressive craniectomy that may avoid many of the complications following such cranioplasty using current methods.

AB - Cranioplasty following decompressive craniectomy is highly associated with complications. Methods for avoiding these complications have been well-documented; however, approaching reconstruction through the previous incision, especially if it was on or very near the bone defect, can sometimes lead to wound dehiscence and infection, with exposure of the artificial bone. For such complicated cases, we propose a multi-staged preparation that includes creating a delayed skin flap for the actual skull reconstruction. Flap was elevated in three stages, with 4 week intervals between each stage to allow for adequate blood supply. Cranioplasty using custom-made implants was then performed. Four patients (age range, 10-25 years) were prepared for skull reconstruction using this technique. During follow-up period for 12 months, no complications, including infections, exposure of the artificial bone, or flap necrosis, were observed. Despite the multiple stages required, we consider that our technique makes a significant contribution to the literature because it suggests a technique for cranioplasty following decompressive craniectomy that may avoid many of the complications following such cranioplasty using current methods.

KW - cranial defect

KW - cranial reconstruction

KW - cranioplasty

KW - delayed phenomenon

UR - http://www.scopus.com/inward/record.url?scp=85067040556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067040556&partnerID=8YFLogxK

U2 - 10.2176/nmc.oa.2018-0283

DO - 10.2176/nmc.oa.2018-0283

M3 - Article

C2 - 30867358

AN - SCOPUS:85067040556

VL - 59

SP - 172

EP - 175

JO - Neurologia Medico-Chirurgica

JF - Neurologia Medico-Chirurgica

SN - 0470-8105

IS - 5

ER -