Efficacy of subcutaneously preserved autologous bone grafts in cranioplasty

Abstract

Objective: To assess the efficacy of reconstruction of a cranial defects with the craniectomy bone graft (bone flap) banked in a subcutaneous pocket of the abdominal wall after emergency decompressive craniotomy. Materials and methods: A retrospective study was performed on five patients who underwent emergency decompressive craniectomy and bone graft placement in the abdominal wall followed by cranioplasty for reconstruction of the cranial defect using the autologous calvarial graft banked in the abdominal wall. Clinical outcome after reconstruction was determined post operatively by the adequacy of the recovered craniectomy graft to achieve satisfactory contour and cosmesis, post op infection, requirement for surgical re-intervention and take up of the graft on one year clinic-radiographic follow up. Results: All five patients had an uneventful recovery with no post operative complications or surgical site infection. Excellent cosmetic results in terms of restoration of cranial contour and symmetry was achieved in all five cases. Clinic-radiographic follow up for one year revealed successful take up of the autologous grafts in all five cases. Conclusion: Subcutaneous storage preserves viability of autogenous calvarial bone grafts. Cranioplasty performed with a subcutaneously preserved craniectomy graft has advantage of no donor site mobidity, excellent cosmesis, and satisfactory take up.

Keywords

• Cranioplasty
• autogenous bone graft
• subcutaneous abdominal pouch