Cranioplasty with Autologous Bone Flaps Cryopreserved with Dimethylsulphoxide: Does Tissue Processing Matter

Area of Science:

• Neurosurgery
• Regenerative Medicine
• Tissue Engineering

Background:

• Decompressive craniectomy is a life-saving procedure.
• Cranioplasty is often required to restore cranial contour and protect the brain.
• Cryopreserved autologous bone is a common graft material for cranioplasty.

Purpose of the Study:

• To evaluate the outcomes of cranioplasty using cryopreserved autologous bone.
• To identify factors influencing complication rates after cranioplasty.
• To assess the viability and safety of cryopreserved bone grafts.

Main Methods:

• Retrospective analysis of 74 patients undergoing cranioplasty with cryopreserved autologous bone.
• Evaluation of storage time, age at cranioplasty, and processing parameters.
• Assessment of bone flap resorption, surgical site infection, and microbial growth inhibition.
• Determination of antibiotic elution and cell viability in thawed bone explants.

Main Results:

• Overall bone flap resorption rate was 21.6%, with 43.7% requiring reoperation.
• Surgical site infection occurred in 6.8% of patients.
• Pediatric patients had a higher incidence of hydrocephalus (26.7%) compared to adults (5.1%).
• Early tissue processing positively influenced cell viability.
• Vancomycin was the only detected antibiotic in the supernatant.

Conclusions:

• Cranioplasty outcomes are multifactorial, influenced by patient, surgical, and bone-related factors.
• Cryopreserved autologous bone requires careful processing to ensure graft viability and minimize complications.
• Further research is needed to optimize cryopreservation techniques and reduce cranioplasty failure rates.