Ethylene oxide sterilization of autologous bone flaps following decompressive craniectomy.
BACKGROUND
In patients undergoing decompressive craniectomy, the bone flap is temporarily preserved either in the subcutaneous tissue of the patient or frozen. However, there are some drawbacks related to these methods.


METHODS
In 16 patients in whom the bone flap was removed for decompressive craniectomy, the bone was firstly washed in hydrogen peroxide and then placed in hermetically-sealed bags and sterilized using ethylene oxide. The bone was repositioned after an average period of 4.3 months.


RESULTS
One patient sustained an infection of the surgical wound which required permanent exclusion of the bone flap. In all the others, esthetic and functional results were good after an average follow-up of 20 months. Control CT-scan of the bone flap demonstrated preservation of its structural features with fusion of the bone margins and revitalization of the flap. On MRI a subdural space was again visible.


CONCLUSIONS
Sterilization of the bone flap with ethylene oxide in patients undergoing decompressive craniectomy avoids some of the drawbacks related to the techniques currently used. The easiness, low cost, good aesthetic and functional results of this procedure make it a valid alternative to other techniques for preservation of autologous bone in decompressive craniectomies.
Neurosurgery and Neurotraumatology, Neuroradiology II and Department of Clinical Medicine, University of Rome La Sapienza, Italy. missorp@yahoo.com
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Missori
F M
FM
Polli
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E
Rastelli
P
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Baiocchi
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Artizzu
G
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Rocchi
M
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Salvati
S
S
Paolini
R
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Delfini
D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D004202:Disinfectants / Q000627:therapeutic use*; D005027:Ethylene Oxide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000601:surgery*; D007427:Intracranial Pressure; D008297:Male; D012886:Skull / Q000601:surgery*; D013242:Sterilization / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D004202:Disinfectants; D005027:Ethylene Oxide