[New tissue preservation method for bone flaps following decompressive craniotomy].

Decompressive craniotomies with removal of the bone flap are still frequently performed in brain injured patients. Usually these bone flaps are refrigerated until reimplantation. In approximately 60% of cranioplasties performed in our clinic by this method we have observed considerable osteolysis especially in the marginal regions. This resulted in a instability which disturbed many patients and required an additional cranioplasty. Other methods for cranioplasty are briefly described. - For the last 3 years we have implanted the removed bone flaps immediately after craniotomy subcutaneously in the abdominal wall instead of preserving them in the refrigerator. By these means we were able to reimplant vital bone during the cranioplasty procedure weeks to months after the initial craniotomy. Our experience with this method shows a significant decrease of resorption in autologous cranioplasties. Out of 43 cases with a follow-up control after one and two years only 2 patients showed signs of resorption. One other bone flap was lost due to infection.