Temporary Skin Lifting Using Elastic Traction for Sinking Skin Flap Syndrome

Area of Science:

• Neurosurgery
• Plastic Surgery
• Medical Device Innovation

Background:

• Sinking skin flap syndrome (SSFS) is a rare complication following decompressive craniectomy.
• Atmospheric pressure exacerbates SSFS by compressing the brain through cranial defects.
• Infection often necessitates delayed cranioplasty, increasing patient vulnerability.

Purpose of the Study:

• To present a case of SSFS following infected implant removal.
• To introduce a temporary skin lifting technique as a bridge therapy for SSFS.
• To evaluate the safety and efficacy of this novel approach.

Main Methods:

• Developed a temporary skin elevation technique using thermoplastic resin and elastic loops.
• Applied the technique to alleviate intracranial compression during infection control.
• Monitored for midline shift, neurological symptoms, and skin complications.

Main Results:

• The elastic traction technique effectively reversed midline shift and neurological symptoms.
• No adverse skin complications were observed during the temporary elevation period.
• Delayed cranioplasty was successfully performed 20 days after skin lifting.

Conclusions:

• Elastic traction-based skin elevation is a safe and effective bridge therapy for SSFS when immediate cranioplasty is contraindicated.
• This technique can mitigate neurological decline during the infection control phase.
• Further clinical investigation is warranted to optimize outcomes in complex SSFS cases.