[Supplementation of cranial defects by an autologous bone flap stored in the abdominal wall]. / Uzupelnianie ubytków kosci pokrywy czaszki autologicznym platem kostnym przechowywanym w powlokach brzucha.

ABSTRACT

BACKGROUND AND PURPOSE: The aim of this paper is to present an alternative method of cranioplasty with the use of an autologous cranial bone flap stored between primary and restorative surgery in the subcutaneous pocket in the lateral hypogastric region. MATERIAL AND METHODS: Between January 1999 and April 2002, in the Department of Neurosurgery of Medical University of Lódz we performed 36 procedures of the bone flap implantation into the abdominal subcutaneous fat tissue. These procedures followed craniectomy, mainly in cases of acute subdural hematomas and ruptured intracranial aneurysms. RESULTS: After storage, the bone flap was reimplanted in 28 patients. The mean time between operations was 14 days (range 8-53 days). In the cranioplasty group we had only one infection of the bone flap. Among patients excluded from the bone flap restoration we observed one inflammatory complication in the abdominal wall and one subcutaneous hematoma requiring evacuation. CONCLUSIONS: In our opinion, the presented method of the cranial defect's supplementation may be competitive to procedures utilizing synthetic prostheses in the population of patients for whom reimplantation of the bone flap will be expected in 2-3 months after the primary operation. Advantages of the procedure are the autologous bone graft, the excellent cosmetic effect, low costs of the procedure and low rate of inflammatory complications.