title: Treatment of very large cranial defects with individually shaped polypropylene polyester knitwear prostheses: a series of 11 cases.
abstract: BACKGROUND
  Very large cranial defects are not very common in neurosurgical practice and there is not any widely acknowledged standard of their treatment. One of the useful methods in such cases is individual forming of polypropylene-polyester knitwear. Such material was used in the past but before 2008 it was available only as standardized plates. Currently, it can be also produced as individually-shaped implants. The authors give their definition of very large cranial defects and present their experience with this cranioplastic method in such defects.
  
  
  METHODS
  The authors collected data on 11 cases of patients with very large cranial defects, from a total of 156 cases, operated on in 5 Polish neurosurgical departments. The necessary implants were prepared for individual patients according to the data provided by a computed tomography examination and with the use of computer aided machining.
  
  
  RESULTS
  All defects were larger than 120 cm2 (129 to 178 cm2) and exceeded 1/4 of the calvaria area. Patients were operated between 2008 to 2012. In all patients, a very good aesthetic result and correct skull reconstruction was achieved. The follow-up time in all cases exceeded 1 year and reached 4 years in one case. No complications were observed.
  
  
  CONCLUSIONS
  Individually pre-shaped polypropylene-polyester knitwear prostheses are a good alternative to the existing cranioplasty methods, particularly in very large cranial defects.
authors.affiliation: Department of Neurosurgery, Medical University of Łódź, Łódź, Poland - piotr001@widzew.net.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kasprzak
authors.affiliation: Independent Engineering Consultant, Łódź, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Tomaszewski
authors.affiliation: Tricomed, Łódź, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Sujka
authors.affiliation: Kazimierz Pulalski University of Technology and Humanities, Radom, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kotwica
authors.affiliation: Department of Neurosurgery, University Medical School in Lublin, Lublin, Poland.
authors.forename: Filip
authors.initials: F
authors.lastname: Stoma
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Borys
authors.initials: B
authors.lastname: Kwinta
authors.affiliation: Department of Neurosurgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Moskała
authors.affiliation: Department of Neurosurgery, Medical University of Łódź, Łódź, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Papierz
authors.affiliation: Department of Neurosurgery, Medical University of Łódź, Łódź, Poland.
authors.forename: Rafał
authors.initials: R
authors.lastname: Wójcik
authors.affiliation: Center for Research and Development, Provincial Specialist Hospital, Wrocław, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Zwoliński
authors.affiliation: Department of Neurosurgery, University Medical School in Lublin, Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Trojanowski
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011126:Polypropylenes; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012886:Skull / Q000601:surgery*; D055815:Young Adult
chemical_list: D011091:Polyesters; D011126:Polypropylenes