New York, N.Y. From the Institute of Reconstructive Plastic Surgery Laboratories, New York University Medical Center, and the New York University College of Dentistry.
Plast Reconstr Surg. 2011 May;127(5):1855-1864. doi: 10.1097/PRS.0b013e31820e89a5.
Although different cranioplasty storage methods are currently in use, no study has prospectively compared these methods. The authors compare freezing and subcutaneous storage methods in a rat model.
Trephine defects (10 mm) were created in 45 Sprague-Dawley rats. The cranial bone grafts were stored in an autologous subcutaneous pocket (n = 15), frozen at -80°C (n = 15), immediately analyzed (n = 12), or immediately replanted into the defect (n = 3). After 10 days of storage, the subcutaneous or frozen grafts were either replanted (subcutaneous, n = 3; frozen, n = 3) or analyzed (subcutaneous, n = 12; frozen, n = 12). Grafts underwent histologic analysis, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, alkaline phosphatase assay, mechanical testing, and micro-computed tomographic imaging.
After 10 days of storage, physiologic assays demonstrated a significant decrease in cellular functionality (e.g., alkaline phosphatase assay concentration: fresh, 18.8 ± 0.77 mM/mg; subcutaneous, 12.2 ± 0.63 mM/mg; frozen, 8.07 ± 1.1 mM/mg; p < 0.012 for all comparisons). Mechanical integrity (maximal load) of fresh grafts was greatest (fresh, 9.26 ± 0.29 N; subcutaneous, 6.27 ± 0.64 N; frozen, 4.65 ± 0.29 N; fresh compared with frozen, p < 0.001; fresh compared with subcutaneous, p = 0.006). Replantation of subcutaneously stored and frozen grafts resulted in limited bony union and considerable resorption after 12 weeks; in contrast, replanted fresh grafts demonstrated bony union and little resorption.
Current preservation methods for interval cranioplasty do not maintain bone graft viability. Subcutaneous storage appears to provide a small advantage compared with freezing.
尽管目前有不同的颅骨修补存储方法，但没有研究前瞻性地比较这些方法。作者在大鼠模型中比较了冷冻和皮下存储方法。
在 45 只 Sprague-Dawley 大鼠中创建了 10mm 的环钻缺陷。颅骨移植物被储存在自体皮下袋中（n = 15），在-80°C 下冷冻（n = 15），立即分析（n = 12），或立即植入缺陷中（n = 3）。储存 10 天后，皮下或冷冻移植物要么被重新植入（皮下，n = 3；冷冻，n = 3），要么被分析（皮下，n = 12；冷冻，n = 12）。移植物进行了组织学分析、3-(4,5-二甲基噻唑-2-基)-2,5-二苯基四唑溴化物（MTT）测定、碱性磷酸酶测定、机械测试和微计算机断层扫描成像。
储存 10 天后，生理测定显示细胞功能显著下降（例如，碱性磷酸酶测定浓度：新鲜，18.8 ± 0.77mM/mg；皮下，12.2 ± 0.63mM/mg；冷冻，8.07 ± 1.1mM/mg；所有比较均 p<0.012）。新鲜移植物的机械完整性（最大负荷）最大（新鲜，9.26 ± 0.29N；皮下，6.27 ± 0.64N；冷冻，4.65 ± 0.29N；新鲜与冷冻相比，p<0.001；新鲜与皮下相比，p=0.006）。皮下储存和冷冻储存的移植物在 12 周后重新植入时仅导致有限的骨融合和大量吸收；相比之下，重新植入的新鲜移植物显示出骨融合和很少的吸收。
目前的颅骨修补间隔期保存方法不能维持骨移植物的活力。与冷冻相比，皮下储存似乎提供了一个小优势。
