caa a22 4500 606215069 CHVBK 20210128101057.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00701-014-2333-0 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2333-0 Complications of cranioplasty using a bone flap sterilised by autoclaving following decompressive craniectomy [Elektronische Daten] [Jan Mracek, Jolana Hommerova, Jan Mork, Patrik Richtr, Vladimir Priban] Background: Increasing use of decompressive craniectomies has led to a corresponding number of cranioplasties performed to replace the subsequent bone defect created. We aimed to evaluate the morbidity associated with cranioplasty using an autologous bone flap sterilised in an autoclave. Methods: We retrospectively analysed data from 149 patients who underwent cranioplasty following decompressive craniectomy during the time period January 1998 to December 2012. Autologous bone flaps were sterilised in an autoclave and stored in a refrigerator at a temperature of 8 degrees above zero until cranioplasty was performed. Complications were registered and patient data were analysed in order to identify risk factors for surgical site infection and bone flap resorption after cranioplasty. Only the patients with a follow-up period of >24months were included in the analysis of bone flap resorption (110 patients). Results: Surgical side infection occurred in only five patients (3.3%), whereas bone flap resorption developed in 22 patients (20%). The multivariate analysis of the presented data identified the operating time of >120min (p = 0.0277; OR, 16.877; 95% CI, 1.364-208.906) and the presence of diabetes mellitus (p = 0.0016; OR, 54.261; 95% CI, 4.529-650.083) as independent risk factors of development of infection and the presence of ventriculo-peritoneal (VP) shunt (p < 0.0001; OR, 35.564; 95% CI, 9.962-126.960) as independent risk factor of development of the bone flap resorption. Conclusions: Reimplantation of the autoclaved autologous bone flap following decompressive craniectomy is a simple and cheep alternative to other techniques and is available to any institution that provides autoclaving sterilisation services. This method is associated with a low rate of surgical site infection, but with a significant rate of the bone flap resorption. Springer-Verlag Wien, 2015 Cranioplasty nationallicence Decompressive craniectomy nationallicence Autoclaving nationallicence Sterilisation nationallicence Complications nationallicence Mracek Jan Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut Hommerova Jolana Department of Neurology, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Pilsen, Czech Republic aut Mork Jan Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut Richtr Patrik Department of Plastic Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Pilsen, Czech Republic aut Priban Vladimir Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 501-506 0001-6268 157:3<501 2015 157 701 https://doi.org/10.1007/s00701-014-2333-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2333-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mracek Jan Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut NATIONALLICENCE 700 1- Hommerova Jolana Department of Neurology, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Pilsen, Czech Republic aut NATIONALLICENCE 700 1- Mork Jan Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut NATIONALLICENCE 700 1- Richtr Patrik Department of Plastic Surgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Pilsen, Czech Republic aut NATIONALLICENCE 700 1- Priban Vladimir Department of Neurosurgery, Faculty of Medicine in Pilsen, Charles University in Prague, Faculty Hospital Pilsen, Alej Svobody 80, 304 60, Pilsen, Czech Republic aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 501-506 0001-6268 157:3<501 2015 157 701