Management of dropped skull flaps
AbdelFatah, Mohamed;
Abstract
Aim: Dropping a skull flap on the floor is an uncommon and avoidable mistake in the neurosurgical operating theater. Mater Ial and Methods: This study retrospectively reviewed all incidents of dropped skull flaps in Ain-Shams University hospitals during a 10-year period to show how to manage this problem and its outcome. Results: Thirty-one incidents of dropped skull flaps occurred from January 2004 to January 2014 out of more than 10,000 craniotomies. Follow-up period varied from 20 to 44 months. The bone flap was dropped while elevating the bone (n = 16), while drilling the bone on the operating table (n = 5), and during insertion of the bone flap (n = 10). Treatment included re-insertion of the skull flap after soaking it in povidone iodine and antibiotic solution (n = 17) or after autoclaving (n = 11), or discarding the skull flap and replacing it with a mesh cranioplasty in the same operation (n = 3). No bone or wound infection was noted during the follow-up period. ConclusIon: Management of dropped skull flap is its prevention. Replacement of the skull flap, after decontamination, is an option that avoids the expense and time of cranioplasty.
Other data
Title | Management of dropped skull flaps | Authors | AbdelFatah, Mohamed | Keywords | Autoclave;Povidone iodine;Dropped skull flap;Craniotomy;Cranioplasty | Issue Date | 1-Jan-2017 | Publisher | TURKISH NEUROSURGICAL SOC | Journal | Turkish neurosurgery | Volume | 27 | Issue | 6 | ISSN | 10195149 | DOI | 10.5137/1019-5149.JTN.16986-16.1 | PubMed ID | 27593838 | Scopus ID | 2-s2.0-85032569454 | Web of science ID | WOS:000417623700008 |
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