Cell and Tissue Banking

, Volume 8, Issue 3, pp 243–246

Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical Center

  • N. Grossman
  • H. S. Shemesh-Jan
  • V. Merkin
  • M. Gideon
  • A. Cohen
Brief Communication

Abstract

Background

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.

Objective

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.

Results

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.

Conclusion

Deep-freeze preservation of autologous bone grafts to reconstruct skull defects after decompressive craniectomy is a useful procedure and has a low revision rate.

Keywords

Autologous bone grafts Decompressive craniectomy Deep-freeze preservation 

Abbreviations

DMSO

Dimethylsulfoxide

OR

Operating room

References

  1. Abbott KH (1953) Use of frozen cranial bone flaps for autogenous, homologous grafts in cranioplasty and spinal interbody fusion. J Neurosurg 10:380–388PubMedGoogle Scholar
  2. 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 26:557–561PubMedCrossRefGoogle Scholar
  3. Asano Y, Ryuke Y, Hasuo M, Simosawa S (1993) Cranioplasty using cryopreserved autogenous bone [in Japanese]. No To Shinkei 45:1145–1150PubMedGoogle Scholar
  4. Elliott H, Scott HJ (1951) The bone-bank in neurosurgery. Br J Surg 39:31–34PubMedCrossRefGoogle Scholar
  5. Hancock DO (1963) The fate of replaced bone flaps. J Neurosurg 20:983–984PubMedGoogle Scholar
  6. Itoh Y (1991) Clinicopathological study of cranioplasty using freeze-preserved autogenous skull [in Japanese]. J Tokyo Med Coll 49:550–564Google Scholar
  7. Korfali E, Aksoy K (1988) Preservation of craniotomy bone flaps under the scalp. Surg Neurol 30:269–272PubMedCrossRefGoogle Scholar
  8. 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) 4:128–132Google Scholar
  9. 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 5:1329–1333PubMedGoogle Scholar
  10. Odom GL, Woodhall B, Wrenn FR Jr (1952) The use of refrigerated autogenous bone flaps for cranioplasty. J Neurosurg 9:606–610PubMedCrossRefGoogle Scholar
  11. Osawa M, Hara H, Ichinose Y, Koyama T, Kobayashi S, Sugita Y (1990) Cranioplasty with a frozen and autoclaved bone flap. Acta Neurochir (Wien) 102:38–41CrossRefGoogle Scholar
  12. Ozaki F (1994) Clinical and experimental study for cranioplasty with autogenous frozen bone graft [in Japanese]. J Wakayama Med Soc 45:217–225Google Scholar
  13. 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 19:153–156PubMedCrossRefGoogle Scholar
  14. Phemister DB (1914) The fate of transplanted bone and regenerative power of its various constituents. Surg Gynecol Obstet 19:303–333Google Scholar
  15. Prolo DJ, Burres KP, McLaughlin WT, Christensen AH (1979) Autogenous skull cranioplasty: fresh and preserved (frozen) with consideration of the cellular response. Neurosurgery 4:18–29PubMedCrossRefGoogle Scholar
  16. 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) 139:970–976CrossRefGoogle Scholar
  17. Yamashita K, Ito H, Wakuta Y (1992) Cranioplasty using autologous bone grafts that had been preserved in a formaldehyde solution [in Japanese]. Keisei Geka 35:1073–1077Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2007

Authors and Affiliations

  • N. Grossman
    • 1
  • H. S. Shemesh-Jan
    • 1
  • V. Merkin
    • 2
  • M. Gideon
    • 2
  • A. Cohen
    • 2
  1. 1.Skin Bank and Investigative Dermatology LaboratorySoroka University Medical CenterBeer ShevaIsrael
  2. 2.Department of NeurosurgerySoroka University Medical CenterBeer ShevaIsrael

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