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颅骨手术后遗留的雷尼夹钛网:病例报告。

Raney clip left behind the titanium mesh after cranial surgery: Case report.

机构信息

Anesthesia and Surgery Center, Chengdu Shang Jin Nan Fu Branch of West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, P. R. China.

出版信息

Medicine (Baltimore). 2024 Jul 26;103(30):e39077. doi: 10.1097/MD.0000000000039077.

Abstract

RATIONALE

Raney clips are commonly used in neurosurgical procedures to hold the scalp in place and stop bleeding during surgery. The removal of Raney clips is often the last process during cranial surgery prior to the closure of skin incision. Thus, a Raney clip found underneath the titanium mesh resulting in fever is a very rare occurrence.

PATIENT CONCERNS

An 18-year-old male patient underwent cranial surgery due to intracranial abscess in the frontal lobe and subsequently underwent frontal skull repair using titanium mesh during which a Raney clip was unintentional left underneath the titanium mesh resulting in fever.

DIAGNOSIS

A thin-slice computed tomography (CT) scan was used to identify the Raney clip.

INTERVENTION

A third surgery was performed to remove the Raney clip.

OUTCOMES

The patient fever total resolved after the third surgery with no further neurological deficits and 2-years follow-up revealed the patient is well and go about his daily activities.

LESSONS

It is crucial to ensure that all foreign objects are removed after the surgery by counting all instruments used at and after each step during the operation, including all Raney clips. This will help prevent complications and ensure the safety as well as the well-being of the patient.

摘要

背景

Raney 夹常用于神经外科手术中,以固定头皮并在手术过程中止血。移除 Raney 夹通常是颅骨手术中在皮肤切口关闭之前的最后一个步骤。因此,在钛网下发现 Raney 夹导致发热是非常罕见的情况。

病例报告

一名 18 岁男性患者因额叶颅内脓肿而行颅骨手术,随后在该部位使用钛网进行了颅骨修复,在此过程中,无意中将一个 Raney 夹留在了钛网下,导致发热。

诊断

采用薄层 CT 扫描来识别 Raney 夹。

干预措施

进行了第三次手术以移除 Raney 夹。

结果

第三次手术后,患者的发热完全消退,无进一步的神经功能缺损。2 年随访显示患者状况良好,日常生活正常。

经验教训

通过在手术过程中的每个步骤(包括所有 Raney 夹)前后进行计数,确保手术完成后移除所有异物非常重要。这将有助于预防并发症,确保患者的安全和健康。

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