Analysis of Decompressive Craniectomies with Subsequent Cranioplasties in the Presence of Collagen Matrix Dural Substitute and XXXX as an Adhesion Preventative Material.

@entity1 @entity410 @entity1276 @entity428 @entity190 @entity260 @entity281 @entity1410 @entity736
OBJECTIVE: Decompressive craniectomy is an established treatment for @entity428 . Cranioplasty is performed once cerebral swelling has resolved. Complications include @entity281 , postoperative fluid collections, @entity1410 , reoperation, and @entity410 . Our experience using a double layer technique during craniectomy with a collagen matrix onlay dural substitute and expanded @entity736 for antiadhesive properties during cranioplasty was reviewed. METHODS: This is a retrospective chart review of 39 consecutive @entity1 who underwent craniectomy with placement of collagen matrix dural onlay and expanded @entity736 and subsequent cranioplasty. Demographic data, size of craniectomy defect, estimated @entity190 , operative time, time between operations, presence of @entity260 were analyzed. RESULTS: Mean operative time was 132 minutes and estimated @entity190 was 112 mL. Overall complication rate was 25.6% and no mortality was encountered. Nine @entity1 had postoperative fluid collections measuring >= 10 mm in thickness and/or 5 mm of midline shift. Two @entity1 required reoperation for these collections. Two @entity1 developed @entity281 requiring bone flap removal. Three @entity1 developed @entity410 after cranioplasty. Five @entity1 required shunt placement for @entity1276 . CONCLUSIONS: Our dual layer closure technique at time of decompressive craniectomy carries a similar reduction in operative time and estimated @entity190 when compared with cranioplasty series with other antiadhesives present. The technique described enables easy dissection of the musculocutaneous flap from the dural plane during cranioplasty and increases the safety of the operation.
