Autogenous skull flaps stored frozen for more than 6 months: do they remain viable?

Bhaskar, Ivan Paul; Li, Yusheng; Zheng, Minghao; Lee, Gabriel Yin Foo

doi:10.1016/j.jocn.2011.02.046

Cited by 29 publications

(24 citation statements)

References 27 publications

(35 reference statements)

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“…One study had shown 50% positive culture bacterial growth on the surface of the bone flaps by flora before storage [14]. Another study had reported that cryopreservation of skull bone flap at À30°C for more than six months shown no viable osteoblasts [15]. On the other hand, 86% of the subcutaneously preserved autologous bone flaps had the presence of osteoblasts [16].…”

Section: Discussionmentioning

confidence: 99%

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Chan

Mok

Lam

et al. 2017

Journal of Clinical Neuroscience

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Craniectomy is a life-saving procedure. Subsequent cranioplasty with autologous skull bone has a bone resorption rate from 4% to 22.8% and an infection rate from 3.3% to 26%. There are concerns with their viability and the potential microbial contamination as they were explanted for a long period of time. Eighteen cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the period from June 2011 to March 2016 were identified. Ethics approval was obtained. Bone chips and deep bone swabs were collected for osteoblast culture and microbial culture. Skull Bone Bank was kept at -80°C under strict aseptic technique during the study period. The storage period ranged from 4months to 55months. For the osteoblast culture, all eighteen bone flaps had no viable osteoblast growth. For the bacterial culture, five had positive bacteria growth (27.8%). Three were Pasteurella multocida and two were Methicillin-resistant Staphylococcus aureus. The mean duration of storage of the infected bone flap was 32.9months (±15.1months) versus 19.9months (±17.9months) of those bone flaps with no bacterial growth (p=0.1716). The mean size of the infected versus non-infected bone flaps was 117.7cm (±44.96cm) versus 76.8cm (±50.24cm) respectively (p=0.1318). Although in this study statistical significance was not reached, it was postulated that infected bone flaps tended to be larger in size and had a longer duration of storage. In conclusion, cryostored skull bone flaps beyond four months showed no viable osteoblasts. Bacterial contamination rate of bone flaps was 27.8% in this study.

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Section: Discussionmentioning

confidence: 99%

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Chan

Mok

Lam

et al. 2017

Journal of Clinical Neuroscience

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show abstract

“…Although Bhaskar et al claim that the bone flaps do not have viable osteoclasts after storage for more than 6 months at -30 degrees Celsius [5]. They also agree that different storage media can affect the preservation of osteoclasts during storage [5]. The storage media used by the Orange County Tissue Bank was different from the storage media used in the Bhaskar et al study.…”

Section: Discussionmentioning

confidence: 84%

“…While the patient's brain and surrounding tissues had been exposed to temozolomide chemotherapy and radiation before the placement of BCNU wafers, the tissue from the bone flap had not been previously exposed to any mutagens. Although Bhaskar et al claim that the bone flaps do not have viable osteoclasts after storage for more than 6 months at -30 degrees Celsius [5]. They also agree that different storage media can affect the preservation of osteoclasts during storage [5].…”

Section: Discussionmentioning

confidence: 99%

Undifferentiated Sarcoma Induced by BCNU (1,3-bis(2-chloroethyl) -1-nitrosourea) Wafers

Alexandru¹,

Linskey²,

Kim³

et al. 2013

J Interdiscipl Histopathol

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Malignant gliomas are the most aggressive type of brain tumor, with poor prognosis after recurrence. The most common site of recurrence is within two centimeters of the resection margin. BCNU (1,3-bis(2-chloroethyl)-1-nitrosourea) wafers (“BNCU wafers”) are used to deliver local high dose chemotherapy around the resection cavity, and serve as a treatment option for treating malignant gliomas in an effort to delay tumor recurrence. We present the case of a fifty three year old woman who developed rapidly progressive sarcoma in her bone flap after the placement of BCNU wafers. Initially the patient underwent resection and conventional radio-chemotherapy treatment for her disease. Once the glioma recurred, a new resection was performed and the patient underwent placement of BCNU wafers. Soon after the placement of the BCNU wafers, an aggressive sarcoma developed in the patient’s bone flap which eroded rapidly through her scalp. The patient died soon after her sarcoma diagnosis. As the patient’s bone flap was not exposed to any mutagens, such as radiation or chemotherapy, and the only chemotherapy the bone flap came into contact with was the nitrosourea from the BCNU wafers, we believe that the local chemotherapy was directly responsible for inducing the rapidly expanding sarcoma which ultimately led to the death of the patient. [J Interdiscipl Histopathol 2013; 1(3.000): 163-167

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“…Major topics on cranioplasty are such as complications, surgical timing, surgical technique, free flap preservation methods, new materials and cost-effectiveness. In a few references, there are efforts to provide and support biological basis for cryopreserved bone flaps 7192841)…”

Section: Introductionmentioning

confidence: 99%

Review of Cranioplasty after Decompressive Craniectomy

Cho

Kang

2017

Korean J Neurotrauma

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Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

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Autogenous skull flaps stored frozen for more than 6 months: do they remain viable?

Cited by 29 publications

References 27 publications

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Cryostored autologous skull bone for cranioplasty? A study on cranial bone flaps’ viability and microbial contamination after deep-frozen storage at −80 °C

Undifferentiated Sarcoma Induced by BCNU (1,3-bis(2-chloroethyl) -1-nitrosourea) Wafers

Review of Cranioplasty after Decompressive Craniectomy

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