conventional_cranioplasty [Neurosurgery Wiki]

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The goal of the study of Sethi et al. was to ascertain the [[efficacy]], [[safety]], and [[comparability]] of ultra-early cranioplasty (CP; defined here as <30 days from the original [[craniectomy]]) to [[conventional cranioplasty]] (defined here as >30 days from the original [[craniectomy]]). A retrospective review of CPs performed between January 2016 and July 2020 was performed. Craniectomies initially performed at other institutions were excluded. Seventy-seven CPs were included in the study. Ultra-early CP was defined as CP performed within 30 days of craniectomy whereas conventional CP occurred after 30 days. Post-operative [[wound infection]] rates, rate of return to the [[operating room]] (OR) with or without bone flap removal, operative length, and rate of post-CP hydrocephalus were compared between the two groups. Thirty-nine and 38 patients were included in the ultra-early and conventional CP groups, respectively. The average number of days to CP in the ultra-early group was 17.70 ± 7.75 days compared to 95.70 ± 65.60 days in the conventional group. The mean Glasgow Coma Scale upon arrival to the emergency room was 7.28 ± 3.90 and 6.92 ± 4.14 for the ultra-early and conventional groups, respectively. The operative time was shorter in the ultra-early cohort than that in the conventional cohort (ultra-early, 2.40 ± 0.71 h; conventional, 3.00 ± 1.63 h; p = 0.0336). The incidence of post-CP hydrocephalus was also lower in the ultra-early cohort (ultra-early, 10.3%; conventional, 31.6%; p = 0.026). No statistically significant differences were observed regarding post-operative infection, return to the OR, or bone flap removal. The study shows that ultra-early CP can significantly reduce the rate of post-CP [[hydrocephalus]], as well as operative time in comparison to conventional CP. However, the timing of CP post-DC should remain a patient-centered consideration
((Sethi A, Chee K, Kaakani A, Beauchamp K, Kang J. Ultra-Early [[Cranioplasty]] versus Conventional Cranioplasty: A Retrospective Cohort Study at an Academic Level 1 Trauma Center. Neurotrauma Rep. 2022 Aug 1;3(1):286-291. doi: 10.1089/neur.2022.0026. PMID: 36060455; PMCID: PMC9438438.))