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. 2011:2:72.
doi: 10.4103/2152-7806.81735. Epub 2011 May 28.

Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall-Experience with 75 cases in a post-war country Kosova

Arsim Morina  1 , Fatos Kelmendi, Qamile Morina, Shefki Dragusha, Feti Ahmeti, Dukagjin Morina, Kushtrim Gashi
Affiliations

Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall-Experience with 75 cases in a post-war country Kosova

Arsim Morina et al. Surg Neurol Int. 2011.

Abstract

Background: The study is to show the advantages of preservation of a calvarial bone flap in the abdominal pocket after decompressive craniotomy. Decompressive craniectomy is an option in the surgical management of refractory hypertension when maximal medical treatment (sedation, drainage of cerebrospinal fluid, moderate cooling, etc) has failed to control refractory high intracranial pressure.

Methods: We have prospectively analyzed 82 consecutively operated cases decompressive craniotomies done at the University Neurosurgical Clinic in Prishtina/KOSOVA over a period of eight years (June 1999 to Aug 2008). Of the 75 who had their grafts replaced (7 patient died before replacement of bone graft), 62 patients had hemicraniectomy (fronto-parieto-temporal) 7 of them were bilateral.

Results: In 66 out of 75 patients was achieved a satisfactory and cosmetically reconstruction, in 9 cases was required augmentation with methyl methacrylate to achieve cosmetic needs. Two patients had infection and the bone was removed; 6 months later these patients had cranioplasty with methyl methacrylate. The duration of storage of calvarial bone in abdominal pouch before reimplantation was 14 - 232 days (range 56 days).

Conclusion: We think that storage of the patients own bone flap in the abdominal pocket is a safe, easy, cheap, sterile, histocompatible, and better cosmetic results.

Keywords: Autogenous bone; bone flap; cranioplasty; subgaleal pocket.

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Figures

Figure 1
Figure 1
Cranial defect before graft replacement
Figure 2
Figure 2
Bone graft in abdominal pocket
Figure 3
Figure 3
Taking the bone out of abdomen
Figure 4
Figure 4
Quality of bone after six months
Figure 5
Figure 5
Three weeks after replacement of bone flap – perfect surgical/cosmetically results L/L view?
Figure 6
Figure 6
Three weeks after replacement of bone flap – perfect surgical/cosmetically results A/P view
See this image and copyright information in PMC

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