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. 2018 Aug 22:9:168.
doi: 10.4103/sni.sni_102_18. eCollection 2018.

Adhesion sutures for seroma reduction in cranial reconstructions with polymethyl methacrylate prosthesis in patients undergoing decompressive craniectomy: A clinical trial

Juan Pablo Borges Rodrigues Maricevich  1 , Auricelio Batista Cezar  2 , Edilson Xavier de Oliveira  1 , Jose Arthur Morais Veras E Silva  1 , Renata Souza Maricevich  3 , Nivaldo Sena Almeida  2 , Hildo Rocha Cirne Azevedo-Filho  2
Affiliations

Adhesion sutures for seroma reduction in cranial reconstructions with polymethyl methacrylate prosthesis in patients undergoing decompressive craniectomy: A clinical trial

Juan Pablo Borges Rodrigues Maricevich et al. Surg Neurol Int. .

Abstract

Background: Cranial reconstruction with polymethyl methacrylate (PMMA) prosthesis is used for calvarial defects secondary to decompressive craniectomies. Seroma is one of the most frequent complications of this procedure and can lead to the dehiscence, extrusion, infection, and loss of the prosthesis. The objective of the study is to analyze the effectiveness of the tacking sutures between the prosthesis and the scalp flap in reducing the seroma.

Methods: This is a prospective study with 63 patients submitted to cranioplasty between 2014 and 2017 for defects resulting from decompressive craniectomies. All patients were followed up postoperatively for at least 3 months and the diagnosis of seroma was made clinically. In the first 22 patients, the conventional technique was applied and, in the following 41, the technique with tacking sutures was used. The incidence of seroma was collected for both groups.

Results: The overall incidence of seroma was 65.1%. Compared to the conventional technique, the use of tacking sutures was associated with a statistically significant reduction in the incidence of seroma from 90.9% to 51.2% (P = 0.002).

Conclusion: The use of the tacking sutures in cranioplasties with PMMA prosthesis reduced the incidence of seroma postoperatively.

Keywords: Cranial reconstruction; cranioplasty; descompressive craniectomy; polymethyl methacrylate; seroma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Fenestration and 3-0 Mononylon® sutures through the prosthesis mainly in the temporal region
Figure 2
Figure 2
Scalp flap and temporal muscle sutured down to the implant after prosthesis fixation
See this image and copyright information in PMC

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