Kim Young Ha, Lee Chi Hyung, Kim Chang Hyeun, Son Dong Wuk, Lee Sang Weon, Song Geun Sung, Sung Soon Ki
Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Korea.
Brain Sci. 2021 Jan 18;11(1):124. doi: 10.3390/brainsci11010124.
(1) Background: Cranioplasty is a surgery to repair a skull bone defect after decompressive craniectomy (DC). If the process of dissection of the epidural adhesion tissue is not performed properly, it can cause many complications. We reviewed the effect of a silicone elastomer sheet designed to prevent adhesion. (2) Methods: We retrospectively reviewed 81 consecutive patients who underwent DC and subsequent cranioplasty at our institution between January 2015 and December 2019. We then divided the patients into two groups, one not using the silicone elastomer sheet ( = 50) and the other using the silicone elastomer sheet ( = 31), and compared the surgical outcomes. (3) Results: We found that the use of the sheet shortened the operation time by 24% and reduced the estimated blood loss (EBL) by 43% compared to the control group. Moreover, the complication rate of epidural fluid collection (EFC) in the group using the sheet was 16.7%, which was lower than that in the control group (41.7%, < 0.023). Multivariate logistic regression analysis showed the sheet (OR 0.294, 95% CI 0.093-0.934, = 0.039) to be significantly related to EFC. (4) Conclusions: The technique using the silicone elastomer sheet allows surgeons to easily dissect the surgical plane during cranioplasty, which shortens the operation time, reduces EBL, and minimizes complications of EFC.
(1) 背景：颅骨修补术是一种在减压性颅骨切除术后修复颅骨骨缺损的手术。如果硬膜外粘连组织的分离过程操作不当，可能会引发多种并发症。我们回顾了一种用于预防粘连的硅橡胶片的效果。(2) 方法：我们回顾性分析了2015年1月至2019年12月期间在我院连续接受减压性颅骨切除术及后续颅骨修补术的81例患者。然后将患者分为两组，一组未使用硅橡胶片（n = 50），另一组使用硅橡胶片（n = 31），并比较手术结果。(3) 结果：我们发现，与对照组相比，使用该片可使手术时间缩短24%，估计失血量（EBL）减少43%。此外，使用该片的组中硬膜外积液（EFC）的并发症发生率为16.7%，低于对照组（41.7%，P < 0.023）。多因素逻辑回归分析显示该片（OR 0.294，95% CI 0.093 - 0.934，P = 0.039）与EFC显著相关。(4) 结论：使用硅橡胶片的技术使外科医生在颅骨修补术中能够轻松分离手术平面，从而缩短手术时间，减少EBL，并将EFC的并发症降至最低。
