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Abdominal craniectomy implantation and thromboembolism prophylaxis resulting in wound hematoma

Kyle M Fargen1, Rohit R Bhasin, Gregory J Murad

  • 1Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida 32610-0265, USA. kyle.fargen@neurosurgery.ufl.edu

Neurosurgery
|July 21, 2010
PubMed

Insights

Craniectomy patients receiving abdominal deep vein thrombosis (DVT) prophylaxis injections developed hematomas at the bone flap implantation site. To prevent these complications, DVT prophylaxis should be administered away from the surgical area.

Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Trauma Surgery

Background:

  • Refractory intracranial hypertension necessitates craniectomy to avert herniation and neurological damage in patients with salvageable brain injuries.
  • Abdominal bone flap implantation is a surgical technique used in craniectomy procedures.

Observation:

  • Three patients who underwent craniectomy with abdominal bone flap implantation developed iatrogenic abdominal hematomas.
  • These hematomas were associated with subcutaneous deep vein thrombosis (DVT) prophylaxis administered via abdominal injections.

Findings:

  • Hematomas occurred at the site of abdominal implantation, with evidence of needle sticks overlying the area.
  • The complications arose 17 days, 20 days, and 6 weeks postoperatively, requiring urgent evacuation.

Implications:

  • Deep vein thrombosis (DVT) prophylaxis injections should be administered at sites remote from the abdominal bone flap implantation area.
  • This strategy aims to minimize the risk of wound hematoma formation in craniectomized patients receiving abdominal bone flap reconstruction.
Abstract

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