Preservation of craniotomy bone flaps under the scalp

Bone flaps are occasionally not replaced because of brain swelling or for other reasons. Various methods for preserving the free bone flaps have been described. Reimplantation of a free bone flap after a period of preservation outside the body, however, may be complicated by infection, and facilities for proper preservation under sterile conditions may not be available. We present a new technique for preserving the bone flap under the scalp until brain swelling has resolved. The bone flap is reimplanted 12-48 days later. No serious complications related to this technique have been encountered in the 37 patients in which it was used.