Autologous Skull Bone Flap Sterilization After Decompressive Craniectomy: An Update

Area of Science:

• Neurosurgery
• Sterilization Techniques
• Biomaterials

Background:

• Decompressive craniectomy often requires bone flap preservation.
• Autologous bone flaps are susceptible to infection and resorption.
• Effective sterilization is crucial for successful bone flap reimplantation.

Purpose of the Study:

• To evaluate ethylene oxide sterilization for bone flaps.
• To assess high- and low-temperature autoclave sterilization for bone flaps.
• To compare preservation outcomes of different sterilization methods.

Main Methods:

• 45 patients undergoing decompressive craniectomy were included.
• Bone flaps were preserved using ethylene oxide or autoclave sterilization (high/low temp).
• Outcomes were assessed based on infection, resorption, aesthetics, and imaging.

Main Results:

• Bone flap infection occurred in 2% of patients, requiring removal.
• Partial bone flap reabsorption was observed in one child.
• Good aesthetic results were achieved in most patients with evidence of flap fusion and revitalization.

Conclusions:

• Ethylene oxide and autoclave sterilization are safe for autologous bone flaps.
• These methods are rapid and cost-effective.
• Successful bone flap preservation is achievable, leading to favorable long-term outcomes.