[Subcutaneous preservation of free skull bone flap taken out in decompressive craniectomy (author's transl)].
The best material for cranioplasty of large skull bone defect as a result of decompressive surgery is a patient's own bone flap, since it fits exactly where it was and no recipient's reactions are elicited. Ideally the bone flap should be alive. However, there have been no effective ways to keep a bone flap alive. We have attempted to preserve a free bone flap in a sterile and living state by keeping it subcutaneously in the thigh. The reasons we choose this site for temporary implantation are as follows: 1) Sufficient space can be easily made to accommodate a bone flap. 2) Curvature of a bone flap fits that of a thigh without difficulties and extreme protrusions caused by implanted bone flap can be avoided. 3) The site of storage is well away from the operative field and independent from each other. 4) It is possible to get the fascia lata through the same skin incision for a large dural patch when needed. When the bone flap is too large to be comfortably accommodated and causes significant stretching and protrusions of the covering skin at the bone edge, it is simply divided into two pieces and these are implanted in the same place.
D003664:Decompression; D006801:Humans; D007427:Intracranial Pressure; D012092:Replantation; D012886:Skull / Q000601:surgery*; D013848:Thigh / Q000601:surgery; D014021:Tissue Preservation / Q000379:methods*