Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical Center
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Decompressive craniectomy is routinely performed in many neurosurgical centers to treat intracranial hypertension refractory to medical therapy as a result of head trauma, CVA or various brain tumors. When the patient survives his illness, cranioplasty with autologous bone graft or other reconstructive materials is considered to repair the skull defect.
This prospective study reviews the cases of decompressive craniectomies followed by later cranioplasty undertaken at our institute through the years 1996 and 2005 and describes the method used for preservation of removed bone flaps for future cranioplasty.
Subjects and methods
Sixty-eight patients underwent decompressive craniectomies since 1996. A protocol was designed to prepare the removed bone flaps for deep freeze preservation. After removal, the bone flaps were transferred to the skin bank at our institution within 6 h, gently rinsed using 1–3 liters of sterile saline (0.9% NaCl) supplemented with antibiotics (neomycin, 2 mM) with no dimethylsulfoxide (DMSO), then flaps were wrapped in two layers of sterile plastic coverage and preserved at −80°C.
The patient’s population will be presented. Since 1996 we have performed 12 cranioplasties using deep-freeze preserved autologous bone graft. It took a rather long learning period, beginning with a single patient per year and continued with several others. Up to now, no case of infection, osteomyelitis or bone resorption following cranioplasty have occurred.
Deep-freeze preservation of autologous bone grafts to reconstruct skull defects after decompressive craniectomy is a useful procedure and has a low revision rate.
- Abbott KH (1953) Use of frozen cranial bone flaps for autogenous, homologous grafts in cranioplasty and spinal interbody fusion. J Neurosurg 10:380–388
- Acikgoz B, Ozcan OE, Erbengi A, Bertan V, Ruacan S, Acikgoz HG (1986) Histopathological and microdensitometric analysis of craniotomy bone flaps preserved between abdominal fat and muscle. Surg Neurol 26:557–561 CrossRef
- Asano Y, Ryuke Y, Hasuo M, Simosawa S (1993) Cranioplasty using cryopreserved autogenous bone [in Japanese]. No To Shinkei 45:1145–1150
- Elliott H, Scott HJ (1951) The bone-bank in neurosurgery. Br J Surg 39:31–34 CrossRef
- Hancock DO (1963) The fate of replaced bone flaps. J Neurosurg 20:983–984
- Itoh Y (1991) Clinicopathological study of cranioplasty using freeze-preserved autogenous skull [in Japanese]. J Tokyo Med Coll 49:550–564
- Korfali E, Aksoy K (1988) Preservation of craniotomy bone flaps under the scalp. Surg Neurol 30:269–272 CrossRef
- Kurokawa Y, Watanabe K, Abiko S, Okamura T, Yokoyama T (1995) Cranioplasty results using decompressed bone flaps preserved in 80% ethanol [in Japanese]. Jpn J Neurosurg (Tokyo) 4:128–132
- Nakajima T, Simeda K, Yamanouchi Y, Matsumura H (1977) Subcutaneous preservation of free bone flap taken out in decompressive craniectomy: a follow-up study [in Japanese]. No Shinkei Geka 5:1329–1333
- Odom GL, Woodhall B, Wrenn FR Jr (1952) The use of refrigerated autogenous bone flaps for cranioplasty. J Neurosurg 9:606–610 CrossRef
- Osawa M, Hara H, Ichinose Y, Koyama T, Kobayashi S, Sugita Y (1990) Cranioplasty with a frozen and autoclaved bone flap. Acta Neurochir (Wien) 102:38–41 CrossRef
- Ozaki F (1994) Clinical and experimental study for cranioplasty with autogenous frozen bone graft [in Japanese]. J Wakayama Med Soc 45:217–225
- Pasaoglu A, Kurtsoy A, Koc RK, Kontas O, Akdemir H, Öktem IS, Selçuklu A, Kavuncu IA (1996) Cranioplasty with bone flaps preserved under the scalp. Neurosurg Rev 19:153–156 CrossRef
- Phemister DB (1914) The fate of transplanted bone and regenerative power of its various constituents. Surg Gynecol Obstet 19:303–333
- 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 CrossRef
- Vanaclocha V, Sáiz-Sapena N, García-Casasola C, De Alava E (1997) Cranioplasty with autogenous autoclaved calvarial bone flap in the cases of tumoral invasion. Acta Neurochir (Wien) 139:970–976 CrossRef
- Yamashita K, Ito H, Wakuta Y (1992) Cranioplasty using autologous bone grafts that had been preserved in a formaldehyde solution [in Japanese]. Keisei Geka 35:1073–1077
- Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical Center
Cell and Tissue Banking
Volume 8, Issue 3 , pp 243-246
- Cover Date
- Print ISSN
- Online ISSN
- Kluwer Academic Publishers
- Additional Links
- Autologous bone grafts
- Decompressive craniectomy
- Deep-freeze preservation
- Author Affiliations
- 1. Skin Bank and Investigative Dermatology Laboratory, Soroka University Medical Center, Post Box 151, Beer Sheva, 84101, Israel
- 2. Department of Neurosurgery, Soroka University Medical Center, Post Box 151, Beer Sheva, 84101, Israel