title: Autologous cranioplasty following decompressive craniectomy in the trauma setting.
abstract: BACKGROUND
  Decompressive craniectomy (DC) is an option for the treatment of increased intracranial pressure resulting from an acute neurological insult, including insults caused by trauma. When the brain swelling has receded, the skull is reconstructed with a wide choice of materials, each with its own advantages and disadvantages in terms of cost, cosmetic appearance, biocompatibility, implant strength and complication rate. Autologous cranioplasty (AC), where the patient's own bone flap is stored and reutilised, is common in many countries. No outcome studies have, however, been published on this technique for traumatic injuries.
  
  
  METHODS
  A retrospective study was conducted including all AC operations performed following DC due to traumatic brain injury. All operations were performed in one institution during a 4-year time period. Results were analysed for complication rates.
  
  
  RESULTS
  44 cases were included. The mean time from craniotomy to cranioplasty was 86 (95% CI: 63-109) days. Complications severe enough to warrant readmission or further surgery were found in 13 cases (30%). No statistically significant predictor of complication from cranioplasty was detected. The complication rate was similar to published data on cranioplasty using artificial prosthetic materials.
  
  
  CONCLUSIONS
  AC in the trauma setting is a valid treatment option with a complication rate that seems no worse than other alternatives.
authors.affiliation: a Department of Neurosurgery , Skane University Hospital , Lund , Sweden.
authors.forename: Wessam
authors.initials: W
authors.lastname: El Ghoul
authors.affiliation: b Department of Neurosurgery , Wessex Neurological Centre, Southampton Hospital University Trust , Southampton , UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Harrisson
authors.affiliation: c NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospitals Birmingham , Birmingham , UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Belli
keywords: complications; cranioplasty; decompressive craniectomy; traumatic brain injury; treatment