Marked reduction in wound complication rates following decompressive hemicraniectomy with an improved operative closure technique
Publication year: 2011 Source: Journal of Clinical Neuroscience, In Press, Corrected Proof, Available online 12 July 2011Michael E., Sughrue , Orin G., Bloch , Geoffrey T., Manley , Shirley I., StiverAlthough decompressive hemicraniectomy with dural expansion and bone flap removal is a potentially life-saving procedure, concerns remain regarding the morbidity associated with this approach. We and others have noted the high rate of wound complications resulting from this technique, often associated with cerebrospinal fluid (CSF) absorption problems. Here, we present our experience with an improved technique for wound closure after unilateral decompressive hemicraniectomy with a wide cruciate durotomy. Data for all patients who underwent a decompressive hemicraniectomy at our institution from October 2005 to October 2009 were gathered prospectively. Starting in mid 2008, we adopted an alternate approach to operative…