Bone flap storage following craniectomy: a survey of practices in major Australian Neurosurgical centres

Abstract

This study has documented highly varied skull flap cryopreservation and storage practices in neurosurgical centres throughout Australia. These differences may contribute to relatively high complication rates of infection and bone resorption reported in the literature. The results of the current study argue for the further need of high quality clinical and basic science research, which aims to characterize the effect of current skull flap management practices and freeze-storage conditions on the biological and biomechanical properties of skull bone.

Cranioplasty after decompressive craniectomy: An institutional audit and analysis of factors related to complications

“…[71016] Current practices relating to cranioplasties are subjective and based either on the surgeon's preferences or institutional policies and there is a void of literature on practices that can potentially minimize the risk of complications. [322]…”

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

“…Bhaskar et al reported that all 25 major Australian neurosurgical institutions surveyed utilized this storage method. 22 Importantly, this study further highlighted the significant variations in techniques and physical conditions (for example, À18°C to À83°C). Similar variations have also been reported elsewhere although the optimal conditions of skull bone storage are not known.…”

Review of Cranioplasty after Decompressive Craniectomy

“…However, there is not a lot of information on how to cryopreserve skull flaps. Bhaskar et al8) reported 96% of 25 neurosurgical centers in Australia used cryopreserved autologous bone flaps for cranioplasty. In his report, 88% of institutions used double or triple gabbed under dry, sterile conditions for packing bone flaps.…”

“…In his report, 88% of institutions used double or triple gabbed under dry, sterile conditions for packing bone flaps. The bone flaps were cryopreserved at temperatures between -18℃ and -83℃ 8). Biomechanical studies reveal that freezing and thawing have little effect on the mechanical properties of the human skull 54).…”

“…The difference of the clinical outcome between synthetic materials and autologous bone graft in cranioplasty is very small 3435394048). Some authors report lower complication with synthetic materials 825262728). Some reports say the total cumulative cost, including complication risks and treatments, was not significantly different between titanium and autologous bone flaps in United States of America & Canada 2450).…”