Autologous Skull Bone for Cranioplasty. A Study on Cranial Bone Flaps’ Viability and Microbial Contamination
Invited conference paper presented and published in conference proceedings


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AbstractObjectives:
Craniectomy is a life-saving procedure. Subsequent cranioplasty has potential complications such as infection (up to 26%)1 or bone resorption (up to 6.5%). Materials for cranioplasty ranged from patients’ own skull bone to artificial substances such as titanium or acrylic. There are concerns with the microbial contamination of autologous skull bone as well as their viability when they are out of the body for a long period of time. However, there is no strong evidence to support these beliefs.

Methods:
Cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the period from June 2011 to March 2016 were identified to be disposed. Inclusion criteria included bone flaps of those patients either already having artificial substance for cranioplasty or passed away after craniectomy. Swabs and bone chips were collected for microbial and osteoblast culture. Ethics approval was obtained (CUHK-NTEC CREC No 2015.708).

Results:
During the study period, 18 pieces of skull bone which fulfilled the inclusion criteria were identified.Tissue Bank was kept at -80°C under strict aseptic technique. The storage period ranged from 4 months to 55 months. For the bacterial culture, five (27.8%) had positive bacteria growth; three of which were Pasteurella multocida. The mean durations of storage of non-contaminated and contaminated bone flaps were 22.5 months and 38.4 months, respectively (P=0.0987). For the osteoblast culture, none had viable osteoblast growth. One fresh intra-operative bone specimen was sent as control with positive osteoblast growth.

Conclusions:
Autologous skull bone flap bacterial contamination rate was 27.8% in this study. None had viable osteoblasts.

Reference:
1. Hall WA. Cranioplasty infections—adding insult to injury. World Neurosurg 2014;82:e435-7.
All Author(s) ListChan Yuen Chung David, Mok YT, Lam Ping Kuen, Sun David, Poon Wai Sang
Name of Conference23rd Annual Scientific Meeting of The Hong Kong Neurosurgical Society
Start Date of Conference25/11/2016
End Date of Conference26/11/2016
Place of ConferenceHong Kong
Country/Region of ConferenceHong Kong
Proceedings TitleHong Kong Medical Journal
Series TitleControversies in Neurosurgery
Year2017
Month6
Volume Number23
Issue NumberSuppl 3
PublisherHong Kong Academy of Medicine Press
Pages40 - 40
ISSN1024-2708
LanguagesEnglish-United Kingdom
KeywordsAutologous Skull Bone for Cranioplasty, Cranial Bone Flaps’ Viability, Microbial Contamination

Last updated on 2018-02-11 at 17:09