Anticoagulation for Hypercoagulable Patients Associated with Complications after Large Cranioplasty Reconstruction

Sankey, Eric W.; Lopez, Joseph; Zhong, Shuting; Susarla, Harlyn K.; Jusué-Torres, Ignacio; Liauw, Jason; Huang, Judy; Streiff, Michael B.; Brem, Henry; Gordon, Chad R.

doi:10.1097/01.prs.0000475773.99148.ba

Cited by 6 publications

(1 citation statement)

References 56 publications

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“…In patients presenting with a history of bleeding dyscrasias, it is helpful to consult a hematologist to assist with perioperative anticoagulation management. 29 Bone fl ap resorption is an overall low risk, but has been seen with both abdominal banking and cryopreservation. It has been shown to be increased when cranioplasty is delayed 14,30 and when the bone fl ap is large (>120 cm 2 ), 31 or comminuted.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

Shakya

Thapa

2019

Nep J Neurosci

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Autologous cranioplasty is an increasingly common procedure performed in neurosurgical centers following a decompressive craniectomy. Available evidence on the safety of autologous bone flap preservation and cranioplasty is limited due to a large diversity in study conducted, nature of pathology and reported outcomes. In this Institutional Review Board-approved retrospective observational study, patients who underwent neurosurgical intervention as“craniectomy followed by cranioplasty” at the Department of Neurological Surgery, Kathmandu Medical College Teaching Hospital were enrolled retrospectively from 1st May 2012 to 30th April2019. The craniectomy bone flap was preserved exvivo, dipped in spirit solution in deep freeze, then autoclaved prior to cranioplasty. Data were collected from the hospital’s electronic database. Information analyzed included patient age, sex, indication forcraniectomy, interval between craniectomy and cranioplasty, length of hospital stay, peri-operativecomplications and mean time of follow-up. Patients who underwent a cranioplasty following removal of an infected bone flap after a craniotomy were excluded from the study. Associated complications were assessed and statistical analysis was performed using a Fisher’s exact test. There were a total of 210 patients with 92vascular, 58 post traumatic. With all these surgeries undergone we had 9% complication rate, all of whom underwent cranioplasty later than four weeks of primary surgery (p = <0.0001).Ex-vivo preservation and autoclaving of bone flap is a simple technique with significant benefits in our hospital and national scenario with significantly less financial burden to patients

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Section: Discussionmentioning

confidence: 99%

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

Shakya

Thapa

2019

Nep J Neurosci

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First In-Human Experience With Complete Integration of Neuromodulation Device Within a Customized Cranial Implant

Gordon

Santiago

Huang³

et al. 2017

Operative Surg.

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Cranial contour irregularities, implant site infection, and bone flap resorption/osteomyelitis are adverse events associated with implantable neurotechnology. This method represents a novel strategy to incorporate all future neuromodulation devices within the confines of a low-profile, computer-designed cranial implant and the newfound potential to eliminate contour irregularities, improve outcomes, and optimize patient satisfaction.

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Long-term Outcomes of Cranioplasty

Kwiecień¹,

Rueda²,

Couto³

et al. 2018

Annals of Plastic Surgery

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Titanium mesh offers a durable repair of isolated bone defects. However, in high-risk patients with soft-tissue defect, the outcomes are significantly worse. In these cases, free tissue transfer for soft-tissue coverage tends to be more successful, especially when using a myocutaneous or fasciocutaneous free flap. This is the first study to identify a high complication rate of this popular material, especially when it is combined with a locoregional scalp flap or free muscle flap. Therefore, in these cases, titanium mesh should be used with caution.

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Anticoagulation for Hypercoagulable Patients Associated with Complications after Large Cranioplasty Reconstruction

Abstract: Therapeutic, III.

Cited by 6 publications

References 56 publications

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

Surgical Outcome of Exvivo Preserved Autologous Cranioplasty - A Novel Approach

First In-Human Experience With Complete Integration of Neuromodulation Device Within a Customized Cranial Implant

Long-term Outcomes of Cranioplasty

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