Summary
27 cases of cranioplasty with autogenous bone grafts stored in a deep-freezer and autoclaved before use are reported. The results of follow-up for an average period of one year were satisfactory from the standpoint of brain protection and cosmetic reconstruction. A small area of absorption of grafted bone was observed in two cases on the follow-up skull roentgenograms. No serious complications were seen except in one case, whose bone flap had to be removed due to an epidural abscess. Experiments revealed that deep-freezing and autoclaving had only minimal effects on bone structure, although osteocytes degenerated. Autogenous bone flap after deep-freezing is a useful material for cranioplasty but sterilization before use is indispensable. Autoclaving is a simple method for sterilization of the flap, available in any operating theatre. It does not increase the risk of postoperative complications such as infection or absorption.
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References
Abbott KH (1953) Use of frozen cranial bone flaps for autogenous homologous grafts. J Neurosurg 10: 380–388
Acikgoz B, Ozcan OE, Erbengi A, Bertan V, Ruacan S, Acikgoz HG (1986) Histopathological and microdensitometri analysis of craniotomy bone flaps preserved between abdominal fat and muscle. Surg Neurol 26: 557–561
Ammar AS (1984) Tissue compatibility of different intracranial implant materials: In-vivo and in-vitro studies. Acta Neurochir (Wien) 72: 45–49
Crotti FM, Mangiagalli EP (1979) Cranial defects repair by replacing bone flaps. J Neurosurg Sci 23: 289–294
De Benedetti G, Marra A, Crivelli G, Pozzi M (1981) A fast, simple, and satisfactory method of cranioplasty. Surg Neurol 15: 358–360
Kobayashi S, Ammar AS, Sugita K, Makinouchi K (1983) Comparative studies on impact strength of human cranium, alumina ceramics and resin. Proc Orthop Ceramic Implants 3: 235–238 (Japanese)
Kobayashi S, Hara H, Okudera H, Takemae T, Sugita K (1987) Usefulness of ceramic implants in neurosurgery. Neurosurgery 21: 751–755
Kreuz FP, Hyatt GW, Turner TC, Bassett AL (1951) The preservation and clinical use of freezed-dried bone. J Bone Joint Surg 33A, 863–872
Nakajima T, Someda K, Yamanouchi Y, Matsumura H (1977) Subcutaneous preservation of free skull bone flap taken out in decompressive craniectomy. A follow-up study. Noshinkeigeka 5 (13): 1329–1333 (Japanese)
Odom GL, Woodhall B, Wrenn FR (1952) The use of refrigerated autogenous bone flaps for cranioplasty. J Neurosurg 9: 606–610
Prolo DJ, Burres KP, McLaughlin WT, Christensen AH (1979) Autogenous skull cranioplasty: Fresh and preserved (frozen), with consideration of the cellular response. Neurosurgery 4: 18–29
Prolo DJ, Oklund SA (1984) Composite autogenic human cranioplasty: Frozen skull supplemented with fresh iliac corticocanellous bone. Neurosurgery 15: 846–851
Prolo D (1985) Cranial defects and cranioplasty. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 1647–1656
Ray BS, Persons H (1947) The replacement of free bone plates in routine craniotomies. J Neurosurg 4: 299–308
Yamada H, Sakai N, Takada M, Ando T, Kagawa Y (1980) Cranioplasty utilizing a preserved autogenous bone flap coated with acrylic resin. Acta Neurochir (Wien) 52, 273–280
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Osawa, M., Hara, H., Ichinose, Y. et al. Cranioplasty with a frozen and autoclaved bone flap. Acta neurochir 102, 38–41 (1990). https://doi.org/10.1007/BF01402184
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DOI: https://doi.org/10.1007/BF01402184