Use of a Dermal Regeneration Template in Complicated Craniotomy Wounds: Review of a Series. Oper Neurosurg (Hagerstown) 2015 Dec 01;11(4):545-553
Date
12/01/2015Pubmed ID
29506168DOI
10.1227/NEU.0000000000000962Scopus ID
2-s2.0-85008343607 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: Surgical wounds after craniotomy heal with primary closure in most cases; however, significant comorbidities, multiple procedures, and history of tumor increase the risk of wound breakdown. Craniotomy wounds often require sophisticated coverage by a plastic surgeon using regional or microvascular flaps to address exposed intracranial contents. Unfortunately, timely treatment of craniotomy wounds may be difficult as a result of limitations of plastic surgery consultation, specialized operating room staffing, and operating room time. Infected wounds may need serial debridement and antibiotic therapy before definitive closure, and patients with dehisced or infected craniotomy wounds may need medical and nutritional optimization.
OBJECTIVE: To present the first case series of 7 neurosurgical patients with craniotomy wound complications who underwent closure with dermal regeneration template (DRT) at the time of urgent surgical debridement.
METHODS: Seven adult patients underwent placement of DRT for dehisced or infected craniotomy wounds after treatment for tumor or trauma. Patients had an average of 5.5 operations before definitive closure. Six patients ultimately underwent delayed free flap transfer after DRT placement, and 1 patient had DRT as definitive coverage.
RESULTS: All patients had healed craniotomy wounds.
CONCLUSION: DRT has a role in treating complicated craniotomy wounds in patients with cancer or trauma either as a bridge or as definitive coverage. Its ease of application does not require advanced or time-consuming techniques. In some cases, it may even be used as a definitive means of closure in surgical wounds.
Author List
LoGiudice JA, Thayer J, Hoyt AT, Mueller WMAuthors
John A. LoGiudice MD Professor in the Plastic Surgery department at Medical College of WisconsinWade M. Mueller MD Professor in the Neurosurgery department at Medical College of Wisconsin
