Paolo Missori1, Daniele Marruzzo2, Sergio Paolini3, Arsen Seferi4, Marco Fricia5, Massimo Chiara1, Valeria Palmarini1, Maurizio Domenicucci1. 1. Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy. 2. Department of Neurology and Psychiatry, Neurosurgery, "Sapienza" University of Rome, Rome, Italy. Electronic address: danielemarruzzo@yahoo.it. 3. Department of Neurosurgery, "Sapienza" University of Rome, IRCCS Neuromed-Pozzilli, Rome, Italy. 4. Department of Neurosurgery, University Hospital Center Mother Theresa, Tirana, Albania. 5. Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy.
Abstract
OBJECTIVE: To report new results with ethylene oxide sterilization and new experiences with autogenous bone flaps autoclaved at a high or low temperature for preservation of a bone flap after decompressive craniectomy. METHODS: In 45 patients who underwent a decompressive craniectomy, we determined bone flap preservation with ethylene oxide and with high- or low-temperature autoclave sterilization. RESULTS: The bone flap was repositioned after a mean of 10 weeks in the ethylene oxide group and after 6 weeks in the other sterilization groups. A bone flap infection developed in 1 patient (2%), which required removal and subsequent methyl methacrylate cranioplasty. In 1 child, the bone flap had partially reabsorbed after 12 months. In all other patients, esthetic results were good after an average follow-up of 42 months. At follow-up, computed tomography or magnetic resonance imaging of the bone flap showed preservation of structural features with apparent fusion and revitalization at the bone flap margins. CONCLUSIONS: Ethylene oxide and high- or low-temperature autoclave bone sterilization techniques for the preservation of autologous bone flaps after decompressive craniectomy were safe, rapid, and inexpensive.
OBJECTIVE: To report new results with ethylene oxide sterilization and new experiences with autogenous bone flaps autoclaved at a high or low temperature for preservation of a bone flap after decompressive craniectomy. METHODS: In 45 patients who underwent a decompressive craniectomy, we determined bone flap preservation with ethylene oxide and with high- or low-temperature autoclave sterilization. RESULTS: The bone flap was repositioned after a mean of 10 weeks in the ethylene oxide group and after 6 weeks in the other sterilization groups. A bone flap infection developed in 1 patient (2%), which required removal and subsequent methyl methacrylate cranioplasty. In 1 child, the bone flap had partially reabsorbed after 12 months. In all other patients, esthetic results were good after an average follow-up of 42 months. At follow-up, computed tomography or magnetic resonance imaging of the bone flap showed preservation of structural features with apparent fusion and revitalization at the bone flap margins. CONCLUSIONS:Ethylene oxide and high- or low-temperature autoclave bone sterilization techniques for the preservation of autologous bone flaps after decompressive craniectomy were safe, rapid, and inexpensive.