[Prevention of osseous defaults in the craneosinostosis surgery using calvarian cranial particulate bone]. / Utilización de hueso craneal particulado de calota para prevención de defectos óseos en la cirugía de las craneosinostosis.

It is considered that up to 20% of the craniosinostosis patients require secondary surgeries. Different techniques have been used in craneofacial surgery for the reconstruction of great osseous defects in pediatric patients for many years. This paper is about a new technique to obtain osseous graft for covering osseous cranial defects, using particulate bone, harvested from the patient calvarian using a hand-driven brace and covered with a fibrin adhesive. This is a very simple technique, which provides a great amount of bone from the patient himself, therefore producing a small morbidity. Since 2007 the authors have been using autologous particulate bone harvested from de patient calvarian for the reconstruction of different size osseous defects found in craneofacial surgery, especially in pediatrics patients. Although alloplastic materials and bone substitutes have been used for cranial reconstruction, the best option is the autogenous bone. In contrast to synthetic materials autologous grafts have a faster osteointegration, due to their osteogenic, osteoinductive and osteconductive properties. Harvesting the bone from the calvarian patient produces a minimal morbidity compared to the extraction of grafts from other donor sites such as rips or hip. The use of autologous particulate bone in craniosinostosis surgery reduces the risk of second interventions due to secondary ossifications defects. On the other hand, the harvest is easy and the supply of bone it is enough in pediatric patients.

Utilización de hueso craneal particulado de calota para prevención de defectosóseos en la cirugía de las craneosinostosis / Prevention of osseous defaults in the craneosinostosis surgery using calvarian cranial particulate bone

considera que hasta un 20% de intervenidos decraneosinostosis requieren cirugías secundarias. Sonvarias las técnicas que se han venido utilizando dentrode la cirugía craneofacial para la reconstrucción degrandes defectos óseos en pacientes pediátricos a lolargo de los años. Presentamos una nueva técnica deobtención de injerto de hueso para el recubrimientode defectos óseos craneales, en la que se utiliza huesoparticulado, obtenido de la calota del paciente medianteun berbiquí y unificado con un adhesivo de fibrina.Está técnica es sencilla y provoca poca morbilidad enel paciente. Además, permite obtener una importantecantidad de hueso.Desde el año 2007 utilizamos el hueso particuladoautólogo obtenido de la calota del paciente para lacorrección de defectos óseos grandes o pequeños que senos presentaban en la cirugía craneofacial practicadasobre todo en pacientes pediátricos.Aunque los materiales aloplásticos y sustitutos dehueso han sido utilizados para la reconstrucción de cráneos,el hueso autógeno es la mejor opción. A diferenciade los materiales sintéticos, los injertos autógenos tienenuna más rápida osteointegración ya que son osteogénicos,osteoinductivos y osteoconductivos, siendo ademásel injerto de la misma naturaleza que el hueso donante.La morbilidad producida al paciente por la obtencióndel hueso de la calota con esta técnica es mínima, encomparación con otras zonas donantes como costilla ocadera.La utilización del hueso particulado autólogodurante la cirugía de las craneosinostosis reduce lanecesidad de segundas intervenciones por defectos deosificación secundarios. Por otro lado, su obtención esfácil y la cantidad de hueso extraído es suficiente paralos pacientes pediátricos (AU)

It is considered that up to 20% of the craniosinostosispatients require secondary surgeries. Differenttechniques have been used in craneofacial surgery forthe reconstruction of great osseous defects in pediatricpatients for many years. This paper is about a newtechnique to obtain osseous graft for covering osseouscranial defects, using particulate bone, harvested fromthe patient calvarian using a hand-driven brace andcovered with a fibrin adhesive. This is a very simpletechnique, which provides a great amount of bone fromthe patient himself, therefore producing a small morbidity.Since 2007 the authors have been using autologousparticulate bone harvested from de patient calvarianfor the reconstruction of different size osseous defectsfound in craneofacial surgery, especially in pediatricspatients.Although alloplastic materials and bone substituteshave been used for cranial reconstruction, the bestoption is the autogenous bone. In contrast to syntheticmaterials autologous grafts have a faster osteointegration,due to their osteogenic, osteoinductive andosteconductive properties. Harvesting the bone fromthe calvarian patient produces a minimal morbiditycompared to the extraction of grafts from other donorsites such as rips or hip.The use of autologous particulate bone in craniosinostosissurgery reduces the risk of second interventionsdue to secondary ossifications defects. On theother hand, the harvest is easy and the supply of bone itis enough in pediatric patients (AU)