Expanded Polytetrafluoroethylene Membrane for Prevention of Adhesions in Patients Undergoing External Decompression and Subsequent Cranioplasty-Technical Note-

Kawaguchi, Tetsuro; Hosoda, Kohkichi; Shibata, Yuji; Koyama, Junji

doi:10.2176/nmc.43.320

Cited by 45 publications

(18 citation statements)

References 13 publications

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“…Much of the modern literature regarding cranioplasty following decompressive craniectomy is based on case series that emphasize the technical aspects of the procedure such as the use of materials, 2,3,9,10,12,14,26,30,33,35,[50][51][52]54,55,60,63,68,70,71 the use of techniques to store the bone flap prior to reconstruction, 16,19,24,25,43,48,49,72 the timing of surgical intervention, 6,37 or other specific modifications to either the craniectomy or cranioplasty procedure, which may influence the cranioplasty. 20,28,34,36,38,41,47,67 There are relatively few modern-day large clinical series describing the clinical outcomes and perioperative complications of cranioplasties in the setting of nonpenetrating traumatic brain injury and large vessel infarction. 40,42 Complications after cranial reconstruction, often viewed as a straightforward neurosurgical procedure, may very well be underreported.…”

mentioning

confidence: 99%

Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases

Gooch

Gin²,

Kenning³

et al. 2009

FOC

373

255

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Object Decompressive craniectomy is a potentially life-saving procedure used in the treatment of medically refractory intracranial hypertension, most commonly in the setting of trauma or cerebral infarction. Once performed, surviving patients are obligated to undergo a second procedure for cranial reconstruction. The complications following cranial reconstruction are not well described in the literature and may very well be underreported. A review of the complications would suggest measures to improve the care of these patients. Methods A retrospective chart review was undertaken of all patients who had undergone cranioplasty during a 7-year period. Demographic data, indications for craniectomy, as well as preoperative, intraoperative, and postoperative parameters following cranioplasty, were recorded. Perioperative and postoperative complications were also recorded. Patients were classified as having no complications, any complications, and complications requiring reoperation. The groups were compared to identify risk factors predictive of poor outcomes. Results The authors identified 62 patients who had undergone cranioplasty. The immediate postoperative complication rate was 34%. Of these, 46 patients did not require reoperation and 16 did. Of those requiring reoperation, 7 were due to infection, 2 from wound breakdown, 2 from intracranial hemorrhage, 3 from bone resorption, and 1 from a sunken cranioplasty, and 1 patient's cranioplasty procedure was prematurely ended due to intraoperative hypotension and bradycardia. The only factor statistically associated with need for reoperation was the presence of a bifrontal cranial defect (bifrontal: 8 [67%] of 12, requiring reoperation; unilateral: 8 [16%] of 49 requiring reoperation; p < 0.01) Conclusions Cranioplasty following decompressive craniectomy is associated with a high complication rate. Patients undergoing a bifrontal craniectomy are at significantly increased risk for postcranioplasty complications, including the need for reoperation.

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mentioning

confidence: 99%

Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases

Gooch

Gin²,

Kenning³

et al. 2009

FOC

373

255

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“…2,4,6,[9][10][11][12][13][14][15][16][17][18][19][20]22 All of these methods would appear reasonable; however, they are not always possible, and in many cases the temporal muscle becomes firmly adherent to the dura especially when pericranial duraplasty has been performed. It is by no means suggested that opening the dura on a temporal muscle pedicle represents a routine form of surgical reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…Examples of these synthetic barriers include silicone, silicon elastomer, bovine pericardium, polytetrafluoroethylene, and Seprafilm. 2,4,6,[9][10][11][12][13][14][15][16][17][18][19][20]22 The following case features an alternative approach to this problem.…”

mentioning

confidence: 99%

Management of the temporal muscle during cranioplasty: technical note

Honeybul

2016

PED

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Over the past 2 decades there has been a resurgence of interest in the use of decompressive craniectomy in the management of neurological emergencies. While technically straightforward, the procedure is associated with a number of complications relating to the initial decompression and subsequent cranioplasty. One complication that has received relatively little attention relates to the management of the temporal muscle. Here, through an illustrative case, the author describes a novel method of minimizing dissection of the temporal muscle during a cranioplasty procedure. Rather than placing a synthetic material over the dura mater to prevent adhesions or dissecting the muscle off the dura, the dura was opened and reflected laterally, pedicled to the temporal muscle. The dural defect was closed with a dural substitute, and the bone flap was secured in a routine fashion. The temporal muscle was then secured in its anatomical position. At the 6-month follow-up, radiological and clinical examination confirmed the restoration of muscle volume with excellent cosmetic and functional results. Opening the dura on a temporal muscle pedicle does not represent a routine form of surgical reconstruction; however, the use of this technique may have some advantages especially in young patients who have made a good recovery and for whom facial aesthetics may be particularly important.

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“…Therefore, we considered whether we could choose a kind of material to be placed between the dura and subcutaneous in the decompressive craniectomy which could be used as artificial isolation layer in the second-stage cranioplasty to make the subcutaneous tissue easy to separate with the decompressive dura, thereby reducing the occurrence of stripping complications. Based on our experiences and previous reports [4][5][6], we have used Dacron heart patch as temporary patch in craniectomy. This method does not interfere with temporal muscle in the second-stage cranioplasty, so the temporal muscle anatomy level had no any change.…”

Section: Introductionmentioning

confidence: 98%

Suturing-Free Artificial Dura with Dacron Heart Patch in Decompressive Craniectomy and Cranioplasty

et al. 2014

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Dacron heart patch has been used in decompressive craniectomy, performing the function of septa, mainly to prevent extra adhesion of temporal muscle and decompressive meningeal adhesion in the second-stage cranioplasty, so as to make the operation easier. Then, we made the following modification technology: (1) We used artificial suturing-free dura participate directly in the duraplasty. (2) Dacron patch is not in need of trimming the side holes and can directly cover the decompression window. From March 2012 to October 2013, we applied the technology of artificial dura with Dacron heart patch in 23 patients; after operation, we found that the initial depressive craniectomy cost less time, due to the tension-reduced suture which was not needed, and in the second-stage cranioplasty, the temporal was easy to remove and had no adhesion with the Dacron patch, so as to reach temporal muscle anatomy preservation, and with no obvious postoperative complication.

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Expanded Polytetrafluoroethylene Membrane for Prevention of Adhesions in Patients Undergoing External Decompression and Subsequent Cranioplasty-Technical Note-

Cited by 45 publications

References 13 publications

Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases

Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases

Management of the temporal muscle during cranioplasty: technical note

Suturing-Free Artificial Dura with Dacron Heart Patch in Decompressive Craniectomy and Cranioplasty

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