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首页> 外文期刊>British journal of neurosurgery >Safety of untreated autologous cranioplasty after extracorporeal storage at - 26 degree celsius
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Safety of untreated autologous cranioplasty after extracorporeal storage at - 26 degree celsius

机译：体外储存-26摄氏度后未经治疗的自体颅骨成形术的安全性

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Background. Given the improved survival of patients requiring decompressive craniectomies, the frequency of subsequent cranioplasties are on the rise. The most feared complication of autologous cranioplasty is infection and one method for reducing the rate of infection, is to store the bone flaps at subnormal temperatures. However, to date there is no defined temperature for flap storage and temperature ranges from - 18 to - 83°C have been described in literature. Considering our limited resources it has been the practice at our center to store bone flaps at - 26°C. In this study, we have retrospectively reviewed our practice and have audited this choice of temperature with respect to the frequency of infections. Methods. A retrospective review was conducted for all cranioplasties performed at our center between January 2001 to March 2011, using autologous bone which was cryopreserved according to institutional protocol. During this period the operative and cryopreservation protocol remained the same. All patient records including charts, notes and laboratory findings were reviewed with a specific focus to identify infections. Results. Of the 88 patients included in the study, only 3 (3.40%) patients were found to show signs of infection. Of these, two patients had superficial surgical site infections which resolved with oral antibiotics (Co-Amoxiclav 1 gm BD for 7 days). However the third patient developed deep surgical site infection requiring re-exploration and washout. All three patients had complete resolution of infection with preservation of autologous bone. Conclusion. Despite our method of keeping the bone flap in freezer at - 26°C we have reported an acceptable rate of infection and raised the notion whether there is a justification for sophisticated and costly equipment for bone flap preservation, especially in resource depleted setups.
机译：背景。考虑到需要减压颅骨切除术的患者生存期的改善，随后的颅骨成形术的频率正在上升。自体颅骨成形术最令人担心的并发症是感染，降低感染率的一种方法是将骨瓣保存在低于正常温度的温度下。然而，迄今为止，没有用于襟翼存储的限定温度，并且文献中已经描述了从-18℃至-83℃的温度范围。考虑到我们有限的资源，在我们中心的惯例是将骨瓣储存在-26°C下。在这项研究中，我们回顾了我们的做法，并就感染频率对这种温度选择进行了审核。方法。我们对2001年1月至2011年3月在我们中心进行的所有颅骨成形术进行了回顾性审查，采用的是根据机构规程冷冻保存的自体骨。在此期间，手术和冷冻保存方案保持不变。审查了所有患者记录，包括图表，注释和实验室检查结果，并特别着眼于识别感染。结果。在研究中包括的88位患者中，只有3位（3.40％）被发现有感染迹象。其中，两名患者患有浅表手术部位感染，可通过口服抗生素（Co-Amoxiclav 1 gm BD持续7天）消退。但是，第三名患者发生了深部手术部位感染，需要重新探查和冲洗。所有三位患者都保留了自体骨，完全治愈了感染。结论。尽管我们采用的方法是将骨瓣在冰箱中保持在-26°C的温度，但我们已经报告了可接受的感染率，并提出了是否有理由使用复杂且昂贵的骨瓣保存设备，特别是在资源贫乏的环境中。

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