Therapeutic Strategies for Retention of Cranioplasty Titanium Mesh After Mesh Exposure

This study seeks to explore the efficacy of utilizing dermal skin pieces as a potential alternative to mesh removal in cases of titanium mesh exposure after cranioplasty, with the goal of preserving the benefits of the rigid prosthesis.

This retrospective study analyzed patients who underwent treatment at the Department of Burns and Wound Repair Surgery of Zibo Central Hospital between January 2018 and November 2022 with the intention of preserving the titanium mesh. The treatment protocol involved initial wound bed management, including debridement of necrotic tissue and eradication of bacteria, followed by the augmentation of dermal thickness using a dermal pad to maintain the integrity of the titanium mesh.

Eight patients, consisting of 6 males and 2 females with a mean age of 47.5 ± 17.5 years (range, 30-65), were included in the study. The exposed area of the mesh varied from 0.3 × 1 to 2 × 3.0 cm, with the thinning scalp area around the exposed titanium mesh ranging from 1.6 × 1.8 to 2 × 2.5 cm. The hospital stay duration ranged from 21 to 40 days, with all 8 patients achieving primary wound healing. No signs of recurrence were observed during the 6 to 18 months of follow-up, and cranial CT scans showed no abnormalities.

In conclusion, the utilization of dermal skin grafts to cover exposed titanium mesh after cranioplasty may facilitate the preservation of the titanium mesh.