title: Cranioplasty Results after Application of Anti-adhesive Films (OrthoWrap™) in Traumatic Decompressive Craniectomy.
abstract: OBJECTIVE
  To determine the effects of application of anti-adhesive films (OrthoWrap™) in traumatic decompressive craniectomy on prevention of adhesion formation and facilitation of subsequent cranioplasty.
  
  
  METHODS
  This was a retrospective cohort study being performed in ShahidRajaei hospital (Shiraz Level I trauma center) during a 12-month period (from March 2012 to April 2013) including 93 patients undergoing traumatic decompressivecraniectomy.Patients who received OrthoWrap™ during the initial craniectomy (n=44) were compared to those who did not (n=49). Two study groups were matched regarding the baseline characteristics. The perioperative indices including the surgical time, amount of bleeding, transfusion and 6-month Glasgow Outcome Scale (GOS) were compared between two study groups.
  
  
  RESULTS
  There was no significant difference between two study groups regarding the baseline characteristics. We found that the cranioplasty duration (113.3±33.2 vs. 146.9±34.9 minutes; p<0.001) and amount of intraoperative bleeding (182.1±98.3 vs. 270.6±77.6 mL; p=0.043) was significantly lower in those who had OrthoWrap™ compared to control group. The final GCS (p=0.052) as well as GOSE (p=0.653) was comparable between groups. The infection rate was comparable between two study groups (p=0.263).
  
  
  CONCLUSIONS
  Application of OrthoWrap™ during decompressive craniectomy in those with severe traumatic brain injury is associated with shorter duration of operation and less intraoperative bleeding in subsequent cranioplasty. Infection rate and neurologic outcome was comparable between study groups.
authors.affiliation: Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran  
authors.forename: Hosseinali
authors.initials: H
authors.lastname: Khalili
authors.affiliation: Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Aydin
authors.initials: A
authors.lastname: Omidvar
authors.affiliation: Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran  
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
authors.affiliation: Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran  
authors.forename: Golnaz
authors.initials: G
authors.lastname: Yadollahikhales
keywords: Anti-adhesive Films (OrthoWrap™); Craniplasty; Decompressive craniectomy