Temporary Skin Lifting Using Elastic Traction for Sinking Skin Flap Syndrome

Sinking skin flap syndrome (SSFS) is a rare but significant complication after decompressive craniectomy, caused by atmospheric pressure compressing the brain through a cranial defect. Although cranioplasty is the primary treatment, infection may delay reconstruction, leaving patients vulnerable to progressive neurological decline. The authors report a case of SSFS after removal of infected cranial implants. To alleviate intracranial compression during the infection control period, the authors developed a temporary skin lifting technique using thermoplastic resin and elastic loops. This method successfully reversed midline shift and neurological symptoms without skin complications. Twenty days after skin lifting, delayed cranioplasty was performed without incident. This case highlights the potential utility of elastic traction-based skin elevation as a safe and effective bridge therapy in SSFS management when early cranioplasty is not feasible. Further clinical application may help optimize outcomes in similar complex cases.