Page 73 - Clinical relevance of current materials for cranial implants

RESULTS
Patient characteristics
This study included 254 patients (165 from the Amsterdam University Medical Centers,
89 from the Elisabeth-Tweesteden Hospital) who underwent a decompressive
craniectomy and cranioplasty with autologous bone in the period 2004-2014. The 3 median age of the patients was 45 years (IQR: 30–53 years), and 51% were males
(n=130). Initial indications for decompressive craniectomy were cerebrovascular
(n=125), traumatic brain injury (n=93), neoplasm (n=25), or infection (n=11). Of the
included patients 12.2% had a smoking habit at the moment of the cranioplasty, 37.7%
did not, 3.1% had quit smoking and in 46.9% smoking habits could not be retrieved.
Median follow-up duration was 175 days (IQR: 55.50–706.3 days) after cranioplasty
(Table 1).
Surgery-specific characteristics
In 236 of the 254 included patients (92.9%) a post-craniectomy CT-scan was performed. Median defect circumference was 38.5cm (IQR 33.4-41.5cm), ranging from 13.5 to 49.7cm. Median time interval between decompressive craniectomy and cranioplasty was 133 days (IQR: 83.0–199.5 days) (Table 1).
Failure of autologous bone flaps
Of the 254 included patients, the autologous bone flap had to be removed in 52 (20.5%) cases (Table 1). Causes of removal were: infection in 24 (46.2%) cases; resorption in 23 (46.2%); subcutaneous fluid collections in 3 (5.8%); and hemorrhage in two (3.8%) cases. This outcome was not influenced by the year in which the surgical interventions were conducted. Characteristics of patients who suffered flap failure due to infection or resorption are shown in Table 1.
Autologous cranioplasty
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