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Published in: Acta Neurochirurgica 4/2014

Open Access 01-04-2014 | Clinical Article - Neurosurgical Techniques

Cranioplasty with autologous cryopreserved bone after decompressive craniectomy. Complications and risk factors for developing surgical site infection

Authors: J. Sundseth, A. Sundseth, J. Berg-Johnsen, W. Sorteberg, K.-F. Lindegaard

Published in: Acta Neurochirurgica | Issue 4/2014

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Abstract

Background

Renewed interest has developed in decompressive craniectomy, and improved survival is shown when this treatment is used after malignant middle cerebral artery infarction. The aim of this study was to investigate the frequency and possible risk factors for developing surgical site infection (SSI) after delayed cranioplasty using autologous, cryopreserved bone.

Methods

This retrospective study included 74 consecutive patients treated with decompressive craniectomy during the time period May 1998 to October 2010 for various non-traumatic conditions causing increased intracranial pressure due to brain swelling. Complications were registered and patient data was analyzed in a search for predictive factors.

Results

Fifty out of the 74 patients (67.6 %) survived and underwent delayed cranioplasty. Of these, 47 were eligible for analysis. Six patients (12.8 %) developed SSI following the replacement of autologous cryopreserved bone, whereas bone resorption occurred in two patients (4.3 %). No factors predicted a statistically significant rate of SSI, however, prolonged procedural time and cardiovascular comorbidity tended to increase the risk of SSI.

Conclusions

SSI and bone flap resorption are the most frequent complications associated with the reimplantation of autologous cryopreserved bone after decompressive craniectomy. Prolonged procedural time and cardiovascular comorbidity tend to increase the risk of SSI.
Literature
1.
go back to reference Abbott KH (1953) Use of frozen cranial bone flaps for autogenous and homologous grafts in cranioplasty and spinal interbody fusion. J Neurosurg 10:380–388PubMedCrossRef Abbott KH (1953) Use of frozen cranial bone flaps for autogenous and homologous grafts in cranioplasty and spinal interbody fusion. J Neurosurg 10:380–388PubMedCrossRef
2.
go back to reference Asano Y, Ryuke Y, Hasuo M, Simosawa S (1993) Cranioplasty using cryopreserved autogenous bone. No To Shinkei 45:1145–1150PubMed Asano Y, Ryuke Y, Hasuo M, Simosawa S (1993) Cranioplasty using cryopreserved autogenous bone. No To Shinkei 45:1145–1150PubMed
3.
go back to reference Bhaskar IP, Zaw NN, Zheng M, Lee GY (2011) Bone flap storage following craniectomy: a survey of practices in major Australian neurosurgical centres. ANZ J Surg 81:137–141PubMedCrossRef Bhaskar IP, Zaw NN, Zheng M, Lee GY (2011) Bone flap storage following craniectomy: a survey of practices in major Australian neurosurgical centres. ANZ J Surg 81:137–141PubMedCrossRef
4.
go back to reference Benzel EC, Thammavvaram K, Kesterson L (1990) The diagnosis of infections associated with acrylic cranioplasties. Neuroradiology 32:151–153PubMedCrossRef Benzel EC, Thammavvaram K, Kesterson L (1990) The diagnosis of infections associated with acrylic cranioplasties. Neuroradiology 32:151–153PubMedCrossRef
5.
go back to reference Blum KS, Schneider SJ, Rosenthal AD (1997) Methyl methacrylate cranioplasty in children: long-term results. Pediatr Neurosurg 26:33–35PubMedCrossRef Blum KS, Schneider SJ, Rosenthal AD (1997) Methyl methacrylate cranioplasty in children: long-term results. Pediatr Neurosurg 26:33–35PubMedCrossRef
6.
go back to reference Cabraja M, Klein M, Lehmann TN (2009) Long-term results following titanium cranioplasty of large skull defects. Neurosurg Focus 26:E10PubMedCrossRef Cabraja M, Klein M, Lehmann TN (2009) Long-term results following titanium cranioplasty of large skull defects. Neurosurg Focus 26:E10PubMedCrossRef
7.
go back to reference Cheng YK, Weng HH, Yang JT, Lee MH, Wang TC, Chang CN (2008) Factors affecting graft infection after cranioplasty. J Clin Neurosci 15:1115–1119PubMedCrossRef Cheng YK, Weng HH, Yang JT, Lee MH, Wang TC, Chang CN (2008) Factors affecting graft infection after cranioplasty. J Clin Neurosci 15:1115–1119PubMedCrossRef
8.
go back to reference Chiang HY, Steelman VM, Pottinger JM, Schlueter AJ, Diekema DJ, Greenlee JD, Howard MA 3rd, Herwaldt LA (2011) Clinical significance of positive cranial bone flap cultures and associated risk of surgical site infection after craniotomies and craniectomies. J Neurosurg 114:1746–1754PubMedCrossRef Chiang HY, Steelman VM, Pottinger JM, Schlueter AJ, Diekema DJ, Greenlee JD, Howard MA 3rd, Herwaldt LA (2011) Clinical significance of positive cranial bone flap cultures and associated risk of surgical site infection after craniotomies and craniectomies. J Neurosurg 114:1746–1754PubMedCrossRef
9.
go back to reference Couldwell WT, Chen TC, Weiss MH, Fukushima T, Dougherty W (1994) Cranioplasty with the Medpor porous polyethylene flexblock implant. Tech Note J Neurosurg 81:483–486CrossRef Couldwell WT, Chen TC, Weiss MH, Fukushima T, Dougherty W (1994) Cranioplasty with the Medpor porous polyethylene flexblock implant. Tech Note J Neurosurg 81:483–486CrossRef
10.
go back to reference Cushing H (1905) The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors; with the description of intermuscular methods of making the bone defect in temporal and occipital regions. Surg Gynecol Obst 1:297–317 Cushing H (1905) The establishment of cerebral hernia as a decompressive measure for inaccessible brain tumors; with the description of intermuscular methods of making the bone defect in temporal and occipital regions. Surg Gynecol Obst 1:297–317
11.
go back to reference Dean D, Min KJ, Bond A (2003) Computer aided design of large-format prefabricated cranial plates. J Craniofac Surg 14:819–832PubMedCrossRef Dean D, Min KJ, Bond A (2003) Computer aided design of large-format prefabricated cranial plates. J Craniofac Surg 14:819–832PubMedCrossRef
12.
go back to reference Diedler J, Sykora M, Blatow M, Jüttler E, Unterberg A, Hacke W (2009) Decompressive surgery for severe brain edema. J Intensive Care Med 24:168–178PubMedCrossRef Diedler J, Sykora M, Blatow M, Jüttler E, Unterberg A, Hacke W (2009) Decompressive surgery for severe brain edema. J Intensive Care Med 24:168–178PubMedCrossRef
13.
go back to reference Eppley BL, Kilgo M, Coleman JJ 3rd (2002) Cranial reconstruction with computer-generated hard-tissue replacement patient-matched implants: indications, surgical technique, and long-term follow-up. Plast Reconstr Surg 109:864–871PubMedCrossRef Eppley BL, Kilgo M, Coleman JJ 3rd (2002) Cranial reconstruction with computer-generated hard-tissue replacement patient-matched implants: indications, surgical technique, and long-term follow-up. Plast Reconstr Surg 109:864–871PubMedCrossRef
14.
go back to reference Fodstad H, Love JA, Ekstedt J, Fridén H, Liliequist B (1984) Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined. Acta Neurochir (Wien) 70:21–30CrossRef Fodstad H, Love JA, Ekstedt J, Fridén H, Liliequist B (1984) Effect of cranioplasty on cerebrospinal fluid hydrodynamics in patients with the syndrome of the trephined. Acta Neurochir (Wien) 70:21–30CrossRef
15.
go back to reference Galicich JH, Hovind KH (1967) Stainless steel mesh-acrylic cranioplasty. Tech Note J Neurosurg 27:376–378CrossRef Galicich JH, Hovind KH (1967) Stainless steel mesh-acrylic cranioplasty. Tech Note J Neurosurg 27:376–378CrossRef
16.
go back to reference Goh RC, Chang CN, Lin CL, Lo LJ (2010) Customiced fabricated implants after previous failed cranioplasty. J Plast Reconstr Aesthet Surg 63:1479–1484PubMedCrossRef Goh RC, Chang CN, Lin CL, Lo LJ (2010) Customiced fabricated implants after previous failed cranioplasty. J Plast Reconstr Aesthet Surg 63:1479–1484PubMedCrossRef
17.
go back to reference Gooch MR, Gin GE, Kenning TJ, German JW (2009) Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases. Neurosurg Focus 26:E9PubMedCrossRef Gooch MR, Gin GE, Kenning TJ, German JW (2009) Complications of cranioplasty following decompressive craniectomy: analysis of 62 cases. Neurosurg Focus 26:E9PubMedCrossRef
18.
go back to reference Grant GA, Jolley M, Ellenbogen RG, Roberts TS, Gruss JR, Loeser JD (2004) Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents. J Neurosurg 100:163–168PubMed Grant GA, Jolley M, Ellenbogen RG, Roberts TS, Gruss JR, Loeser JD (2004) Failure of autologous bone-assisted cranioplasty following decompressive craniectomy in children and adolescents. J Neurosurg 100:163–168PubMed
19.
go back to reference Grossmann N, Shemesh-Jan HS, Merkin V, Gideon M, Cohen A (2007) Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical Center. Cell Tissue Bank 8:243–246CrossRef Grossmann N, Shemesh-Jan HS, Merkin V, Gideon M, Cohen A (2007) Deep-freeze preservation of cranial bones for future cranioplasty: nine years of experience in Soroka University Medical Center. Cell Tissue Bank 8:243–246CrossRef
20.
go back to reference Hammon WM, Kempe LG (1971) Methyl methacrylate cranioplasty. 13 years experience with 417 patients. Acta Neurochir (Wien) 25:69–77CrossRef Hammon WM, Kempe LG (1971) Methyl methacrylate cranioplasty. 13 years experience with 417 patients. Acta Neurochir (Wien) 25:69–77CrossRef
22.
go back to reference Hervás I, Floria LM, Bello P, Baquero MC, Peréz R, Barea J, Iglesias ME, Mateo A (2001) Microvascularized fibular graft for mandibular reconstruction: detection of viability by bone scintigraphy and SPECT. Clin Nucl Med 26:225–229PubMedCrossRef Hervás I, Floria LM, Bello P, Baquero MC, Peréz R, Barea J, Iglesias ME, Mateo A (2001) Microvascularized fibular graft for mandibular reconstruction: detection of viability by bone scintigraphy and SPECT. Clin Nucl Med 26:225–229PubMedCrossRef
23.
go back to reference Hoffmann B, Sepehrnia A (2005) Tailored implants for alloplastic cranioplasty—clinical and surgical considerations. Acta Neurochir Suppl 93:127–129PubMedCrossRef Hoffmann B, Sepehrnia A (2005) Tailored implants for alloplastic cranioplasty—clinical and surgical considerations. Acta Neurochir Suppl 93:127–129PubMedCrossRef
24.
go back to reference Huang YH, Yang TM, Lee TC, Chen WF, Yang KY (2013) Acute autologous bone flap infection after cranioplasty for postinjury decompressive craniectomy. Injury 44:44–47PubMedCrossRef Huang YH, Yang TM, Lee TC, Chen WF, Yang KY (2013) Acute autologous bone flap infection after cranioplasty for postinjury decompressive craniectomy. Injury 44:44–47PubMedCrossRef
25.
go back to reference Inamasu J, Kuramae T, Nakatsukasa M (2010) Does difference in the storage method of bone flaps after decompressive craniectomy affect the incidence of surgical site infection after cranioplasty? Comparison between subcutaneous pocket and cryopreservation. J Trauma 68:183–187PubMedCrossRef Inamasu J, Kuramae T, Nakatsukasa M (2010) Does difference in the storage method of bone flaps after decompressive craniectomy affect the incidence of surgical site infection after cranioplasty? Comparison between subcutaneous pocket and cryopreservation. J Trauma 68:183–187PubMedCrossRef
26.
go back to reference Iwama T, Yamada J, Imai S, Shinoda J, Funakoshi T, Sakai N (2003) The use of frozen autogenous bone flaps in delayed cranioplasty revisited. Neurosurgery 52:591–596PubMedCrossRef Iwama T, Yamada J, Imai S, Shinoda J, Funakoshi T, Sakai N (2003) The use of frozen autogenous bone flaps in delayed cranioplasty revisited. Neurosurgery 52:591–596PubMedCrossRef
27.
go back to reference Joffe J, Harris M, Kahugu F, Nicoll S, Linney A, Richards R (1999) A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome. Br J Neurosurg 13:576–580PubMedCrossRef Joffe J, Harris M, Kahugu F, Nicoll S, Linney A, Richards R (1999) A prospective study of computer-aided design and manufacture of titanium plate for cranioplasty and its clinical outcome. Br J Neurosurg 13:576–580PubMedCrossRef
28.
go back to reference Kim H, Sung SO, Kim SJ, Kim SR, Park IS, Jo KW (2013) Analysis of the factors affecting graft infection after cranioplasty. Acta Neurochir (Wien) 155:2171–2176CrossRef Kim H, Sung SO, Kim SJ, Kim SR, Park IS, Jo KW (2013) Analysis of the factors affecting graft infection after cranioplasty. Acta Neurochir (Wien) 155:2171–2176CrossRef
29.
go back to reference Kuo JR, Wang CC, Chio CC, Cheng TJ (2004) Neurological improvement after cranioplasty—analysis by transcranial doppler ultrasonography. J Clin Neurosci 11:486–489PubMedCrossRef Kuo JR, Wang CC, Chio CC, Cheng TJ (2004) Neurological improvement after cranioplasty—analysis by transcranial doppler ultrasonography. J Clin Neurosci 11:486–489PubMedCrossRef
30.
go back to reference Lee CH, Chung YS, Lee SH, Yang HJ, Son YJ (2012) Analysis of the factors influencing bone graft infection after cranioplasty. J Trauma Acute Care Surg 73:255–260PubMedCrossRef Lee CH, Chung YS, Lee SH, Yang HJ, Son YJ (2012) Analysis of the factors influencing bone graft infection after cranioplasty. J Trauma Acute Care Surg 73:255–260PubMedCrossRef
31.
go back to reference Lee SC, Wu CT, Lee ST, Chen PJ (2009) Cranioplasty using polymethyl methacrylate prostheses. J Clin Neurosci 16:56–63PubMedCrossRef Lee SC, Wu CT, Lee ST, Chen PJ (2009) Cranioplasty using polymethyl methacrylate prostheses. J Clin Neurosci 16:56–63PubMedCrossRef
32.
go back to reference Lu Y, Hui G, Liu F, Wang Z, Tang Y, Gao S (2012) Survival and regeneration of deep-freeze preserved autologous cranial bones after cranioplasty. Br J Neurosurg 26:216–221PubMedCrossRef Lu Y, Hui G, Liu F, Wang Z, Tang Y, Gao S (2012) Survival and regeneration of deep-freeze preserved autologous cranial bones after cranioplasty. Br J Neurosurg 26:216–221PubMedCrossRef
33.
go back to reference Manson PN, Crawley WA, Hoopes JE (1986) Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material. Plast Reconstr Surg 77:888–904PubMedCrossRef Manson PN, Crawley WA, Hoopes JE (1986) Frontal cranioplasty: risk factors and choice of cranial vault reconstructive material. Plast Reconstr Surg 77:888–904PubMedCrossRef
34.
go back to reference Matsuno A, Tanaka H, Iwamuro H, Takanashi S, Miyawaki S, Nakashima M, Nakaguchi H, Nagashima T (2006) Analyses of the factors influencing bone graft infection after delayed cranioplasty. Acta Neurochir (Wien) 148:535–540CrossRef Matsuno A, Tanaka H, Iwamuro H, Takanashi S, Miyawaki S, Nakashima M, Nakaguchi H, Nagashima T (2006) Analyses of the factors influencing bone graft infection after delayed cranioplasty. Acta Neurochir (Wien) 148:535–540CrossRef
35.
go back to reference Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V (2003) Clinical outcome in cranioplasty: critical review in long-term follow-up. J Craniofac Surg 14:144–153PubMedCrossRef Moreira-Gonzalez A, Jackson IT, Miyawaki T, Barakat K, DiNick V (2003) Clinical outcome in cranioplasty: critical review in long-term follow-up. J Craniofac Surg 14:144–153PubMedCrossRef
36.
go back to reference Morina A, Kelmendi F, Morina Q, Dragusha S, Ahmeti F, Morina D, Gashi K (2011) Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall—Experience with 75 cases in a post-war country Kosova. Surg Neurol Int 2:72PubMedCentralPubMedCrossRef Morina A, Kelmendi F, Morina Q, Dragusha S, Ahmeti F, Morina D, Gashi K (2011) Cranioplasty with subcutaneously preserved autologous bone grafts in abdominal wall—Experience with 75 cases in a post-war country Kosova. Surg Neurol Int 2:72PubMedCentralPubMedCrossRef
37.
go back to reference Nagayama K, Yoshikawa G, Somekawa K, Kohno M, Segawa H, Sano K, Shiokawa Y, Saito I (2002) Cranioplasty using the patient’s autogenous bone preserved by freezing. An examination of postoperative infection rates. No Shinkei Geka 30:165–169PubMed Nagayama K, Yoshikawa G, Somekawa K, Kohno M, Segawa H, Sano K, Shiokawa Y, Saito I (2002) Cranioplasty using the patient’s autogenous bone preserved by freezing. An examination of postoperative infection rates. No Shinkei Geka 30:165–169PubMed
38.
go back to reference Odom GL, Woodhall B, Wrenn FR Jr (1952) The use of refrigerated autogenous bone flaps for cranioplasty. J Neurosurg 9:606–610PubMedCrossRef Odom GL, Woodhall B, Wrenn FR Jr (1952) The use of refrigerated autogenous bone flaps for cranioplasty. J Neurosurg 9:606–610PubMedCrossRef
39.
go back to reference Oh JH, Zöller JE, Kübler A (2002) A new bone banking technique to maintain osteoblast viability in frozen human iliac cancellous bone. Cryobiology 44:279–287PubMedCrossRef Oh JH, Zöller JE, Kübler A (2002) A new bone banking technique to maintain osteoblast viability in frozen human iliac cancellous bone. Cryobiology 44:279–287PubMedCrossRef
40.
go back to reference Ozaki F (1994) Clinical and experimental study for cranioplasty with autogenous frozen bone graft (in Japanese). J Wakayama Med Soc 45:217–225 Ozaki F (1994) Clinical and experimental study for cranioplasty with autogenous frozen bone graft (in Japanese). J Wakayama Med Soc 45:217–225
41.
go back to reference Piedra MP, Ragel BT, Dogan A, Coppa ND, Delashaw JB (2013) Timing of cranioplasty after decompressive craniectomy for ischemic or hemorrhagic stroke. J Neurosurg 118:109–114PubMedCrossRef Piedra MP, Ragel BT, Dogan A, Coppa ND, Delashaw JB (2013) Timing of cranioplasty after decompressive craniectomy for ischemic or hemorrhagic stroke. J Neurosurg 118:109–114PubMedCrossRef
42.
go back to reference Prolo DJ, Burres KP, McLaughlin WT, Christensen AH (1979) Autogenous skull cranioplasty: fresh and preserved (frozen), with consideration of the cellular response. Neurosurgery 4:18–29PubMedCrossRef Prolo DJ, Burres KP, McLaughlin WT, Christensen AH (1979) Autogenous skull cranioplasty: fresh and preserved (frozen), with consideration of the cellular response. Neurosurgery 4:18–29PubMedCrossRef
43.
go back to reference Rish BL, Dillon JD, Meirowsky AM, Caveness WF, Mohr JP, Kistler JP, Weiss GH (1979) Cranioplasty: a review of 1,030 cases of penetrating head injury. Neurosurgery 4:381–385PubMedCrossRef Rish BL, Dillon JD, Meirowsky AM, Caveness WF, Mohr JP, Kistler JP, Weiss GH (1979) Cranioplasty: a review of 1,030 cases of penetrating head injury. Neurosurgery 4:381–385PubMedCrossRef
44.
go back to reference Scarcella G (1956) Encephalomalacia simulating the clinical and radiological aspects of brain tumor; a report of 6 cases. J Neurosurg 13:278–292PubMedCrossRef Scarcella G (1956) Encephalomalacia simulating the clinical and radiological aspects of brain tumor; a report of 6 cases. J Neurosurg 13:278–292PubMedCrossRef
45.
go back to reference Schuss P, Vatter H, Oszvald A, Marquardt G, Imöhl L, Seifert V, Güresir E (2013) Bone lap resorption: risk factors for the development of a long-term complication following cranioplasty after decompressive craniectomy. J Neurotrauma 30:91–95PubMedCrossRef Schuss P, Vatter H, Oszvald A, Marquardt G, Imöhl L, Seifert V, Güresir E (2013) Bone lap resorption: risk factors for the development of a long-term complication following cranioplasty after decompressive craniectomy. J Neurotrauma 30:91–95PubMedCrossRef
46.
go back to reference Stoodley MA, Abbott JR, Simpson DA (1996) Titanium cranioplasty using 3-D computer modelling of skull defects. J Clin Neurosci 3:149–155PubMedCrossRef Stoodley MA, Abbott JR, Simpson DA (1996) Titanium cranioplasty using 3-D computer modelling of skull defects. J Clin Neurosci 3:149–155PubMedCrossRef
47.
go back to reference Sundseth J, Berg-Johnsen J (2013) Prefabricated patient-matched cranial implants for reconstruction of large skull defects. J Cent Nerv Syst Dis 5:19–24PubMedCentralPubMedCrossRef Sundseth J, Berg-Johnsen J (2013) Prefabricated patient-matched cranial implants for reconstruction of large skull defects. J Cent Nerv Syst Dis 5:19–24PubMedCentralPubMedCrossRef
48.
go back to reference Tokoro K, Chiba Y, Tsubone K (1989) Late infection after cranioplasty-review of 14 cases. Neurol Med Chir (Tokyo) 29:196–201CrossRef Tokoro K, Chiba Y, Tsubone K (1989) Late infection after cranioplasty-review of 14 cases. Neurol Med Chir (Tokyo) 29:196–201CrossRef
49.
go back to reference Vahedi K, Hofmeijer J, Juettler E, Vicaut E, George B, Algra A, Amelink GJ, Schmiedeck P, Schwab S, Rothwell PM, Bousser MG, van der Worp HB, Hacke W, for the DECIMAL, DESTINY, and HAMLET investigators, (2007) Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 6:215–222PubMedCrossRef Vahedi K, Hofmeijer J, Juettler E, Vicaut E, George B, Algra A, Amelink GJ, Schmiedeck P, Schwab S, Rothwell PM, Bousser MG, van der Worp HB, Hacke W, for the DECIMAL, DESTINY, and HAMLET investigators, (2007) Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. Lancet Neurol 6:215–222PubMedCrossRef
50.
go back to reference Walcott BP, Kwon CS, Sheth SA, Fehnel CR, Koffie RM, Asaad WF, Nahed BV, Coumans JV (2013) Predictors of cranioplasty complications in stroke and trauma patients. J Neurosurg 118:757–762PubMedCrossRef Walcott BP, Kwon CS, Sheth SA, Fehnel CR, Koffie RM, Asaad WF, Nahed BV, Coumans JV (2013) Predictors of cranioplasty complications in stroke and trauma patients. J Neurosurg 118:757–762PubMedCrossRef
51.
go back to reference Winkler PA, Stummer W, Linke R, Krishnan KG, Tatsch K (2000) Influence of cranioplasty on postural blood flow regulation, cerebrovascular reserve capacity, and cerebral glucose metabolism. J Neurosurg 93:53–61PubMedCrossRef Winkler PA, Stummer W, Linke R, Krishnan KG, Tatsch K (2000) Influence of cranioplasty on postural blood flow regulation, cerebrovascular reserve capacity, and cerebral glucose metabolism. J Neurosurg 93:53–61PubMedCrossRef
52.
go back to reference Won YD, Yoo DS, Kim KT, Kang SG, Lee SB, Kim DS, Hahn ST, Huh PW, Cho KS, Park CK (2008) Cranioplasty effect on the cerebral hemodynamics and cardiac function. Acta Neurochir Suppl 102:15–20PubMedCrossRef Won YD, Yoo DS, Kim KT, Kang SG, Lee SB, Kim DS, Hahn ST, Huh PW, Cho KS, Park CK (2008) Cranioplasty effect on the cerebral hemodynamics and cardiac function. Acta Neurochir Suppl 102:15–20PubMedCrossRef
53.
go back to reference Zingale A, Albanese V (2003) Cryopreservation of autogenous bone flap in cranial surgical practice: what is the future? A grade B and evidence level 4 meta-analytic study. J Neurosurg Sci 47:137–139PubMed Zingale A, Albanese V (2003) Cryopreservation of autogenous bone flap in cranial surgical practice: what is the future? A grade B and evidence level 4 meta-analytic study. J Neurosurg Sci 47:137–139PubMed
Metadata
Title
Cranioplasty with autologous cryopreserved bone after decompressive craniectomy. Complications and risk factors for developing surgical site infection
Authors
J. Sundseth
A. Sundseth
J. Berg-Johnsen
W. Sorteberg
K.-F. Lindegaard
Publication date
01-04-2014
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2014
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-013-1992-6

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