Evaluation of locally manufactured patient-specific custom made implants for cranial defects using a silicone mould.
S Afr J Surg
; 56(3): 38-42, 2018 Sep.
Article
in En
| MEDLINE
| ID: mdl-30264941
ABSTRACT
BACKGROUND:
Cranial vault defects can pose a significant problem for neurosurgeons where autologous bone is no longer available for cranioplasty. Numerous materials exist to create implants which include polymethyl methacrylate (PMMA) and titanium. A technique using 3-dimensional CT scan reconstruction of a cranial defect and creating a silicon mould which can be autoclaved in theatre to create a PMMA implant was developed.OBJECTIVE:
The aim of this study is to evaluate the efficacy, cosmetic result, safety and cost-effectiveness of this procedure and compare this to existing techniques.METHOD:
An ambispective study was performed in patients requiring cranioplasty with a custom made implant. Patients were assessed for risk factors and cosmetic outcome, surgical technique was described and complications and cost compared to existing literature between 2010 and 2016.RESULTS:
Thirty retrospective and 30 consecutive prospective patients were recruited into the study. Overall sepsis rate was 8.3%. All septic cases had superficial sepsis of which 2 grafts were removed due to cerebrospinal fluid leakage resulting in wound breakdown. A 100% accurate implant to defect ratio was achieved leading to a high satisfaction rate. Average cost was 5 times cheaper than the closest market related product.CONCLUSION:
Patient specific moulds using PMMA to create custom implants are safe, have excellent cosmetic results and are a very cost-effective option to manage cranial defects. Accurate planning strategies for large craniotomies, where bone will potentially be discarded, add to surgical effectiveness and cost-saving to the patient.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prosthesis Design
/
Polymethyl Methacrylate
/
Prosthesis Implantation
/
Plastic Surgery Procedures
/
Craniotomy
/
Imaging, Three-Dimensional
Type of study:
Etiology_studies
/
Evaluation_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
S Afr J Surg
Year:
2018
Document type:
Article