Abstract：Craniectomy is a life-saving procedure. Subsequent cranioplasty with autologous skull bone has a bone resorption rate from 4% to 22.8% and an infection rate from 3.3% to 26%. There are concerns with their viability and the potential microbial contamination as they were explanted for a long period of time. Eighteen cranial bone flaps stored at Prince of Wales Hospital Skull Bone Bank during the period from June 2011 to March 2016 were identified. Ethics approval was obtained. Bone chips and deep bone swabs were collected for osteoblast culture and microbial culture. Skull Bone Bank was kept at -80°C under strict aseptic technique during the study period. The storage period ranged from 4months to 55months. For the osteoblast culture, all eighteen bone flaps had no viable osteoblast growth. For the bacterial culture, five had positive bacteria growth (27.8%). Three were Pasteurella multocida and two were Methicillin-resistant Staphylococcus aureus. The mean duration of storage of the infected bone flap was 32.9months (±15.1months) versus 19.9months (±17.9months) of those bone flaps with no bacterial growth (p=0.1716). The mean size of the infected versus non-infected bone flaps was 117.7cm2 (±44.96cm2) versus 76.8cm2 (±50.24cm2) respectively (p=0.1318). Although in this study statistical significance was not reached, it was postulated that infected bone flaps tended to be larger in size and had a longer duration of storage. In conclusion, cryostored skull bone flaps beyond four months showed no viable osteoblasts. Bacterial contamination rate of bone flaps was 27.8% in this study.

Autologous; Cranial bone flaps; Craniectomy; Cranioplasty; Cryostored.

David Yuen Chung Chan 1, Yi Tan Mok 2, Ping Kuen Lam 3, Cindy See Wai Tong 4, Stephanie Chi Ping Ng 5, Tin Fung David Sun 6, Wai Sang Poon 7

1、Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. Electronic address: davidchan@surgery.cuhk.edu.hk. 2、Operating Theatre, Prince of Wales Hospital, Hong Kong. Electronic address: myt372@ha.org.hk. 3、Chow Tai Fook - Cheung Yu Tung Surgical Stem Cell Research Centre, The Chinese University of Hong Kong, Hong Kong. Electronic address: pklam@surgery.cuhk.edu.hk. 4、Chow Tai Fook - Cheung Yu Tung Surgical Stem Cell Research Centre, The Chinese University of Hong Kong, Hong Kong. Electronic address: cindytong@surgery.cuhk.edu.hk. 5、Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. Electronic address: stephanieng@surgery.cuhk.edu.hk. 6、Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong. Electronic address: davidsun@surgery.cuhk.edu.hk. 7、Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong; Chow Tai Fook - Cheung Yu Tung Surgical Stem Cell Research Centre, The Chinese University of Hong Kong, Hong Kong. Electronic address: wpoon@cuhk.edu.hk.

J Clin Neurosci

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2017

自体颅骨

28431953

10.1016/j.jocn.2017.04.016