Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (26): 4237-4242.doi: 10.3969/j.issn.2095-4344.1366

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Basic and clinical research progress of autologous skull as a material for cranioplasty

Yan Ke1, Lu Lichun1, Zhao Haifeng2, Wang Weihua1, Zhu Wenyu1, Huang Qiang3
  

  1. 1Department of Neurosurgery, 2Department of Pathology, Suzhou Hospital of Nanjing Medical University, Suzhou Science and Technology Town Hospital, Suzhou 215153, Jiangsu Province, China; 3Department of Neurosurgery, the Second Affiliated Hospital of Suzhou University, Suzhou 215004, Jiangsu Province, China
  • Received:2019-03-26
  • Contact: Zhu Wenyu, Master, Associate chief physician, Department of Neurosurgery, Suzhou Hospital of Nanjing Medical University, Suzhou Science and Technology Town Hospital, Suzhou 215153, Jiangsu Province, China
  • About author:Yan Ke, Master, Department of Neurosurgery, Suzhou Hospital of Nanjing Medical University, Suzhou Science and Technology Town Hospital, Suzhou 215153, Jiangsu Province, China
  • Supported by:

    Livelihood Creation Project of Suzhou Science and Technology Bureau No. SYS2018013 (to ZWY)

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Abstract:

BACKGROUND: During cranioplasty, skull autografts have irreplaceable advantages because of its homology and low cost. However, skull autografts have not be preferred and tend to be substituted by 3D titanium mesh because they can be absorbed after re-implantation.
OBJECTIVE: To summarize the recent advances in re-implantation of skull autografts in clinical and animal experiments and the possible mechanisms underlying absorption of skull autugrafts.
METHODS: Clinical and animal studies related to cranioplasty with skull autografts published during January 1990-January 2019 in PubMed, China Biomedical Literature Database (CBMdisc), Wanfang Database and CNKI were retrieved.
RESULTS AND CONCLUSION: Clinically, the infection rate and absorption rate after re-implantation of skull autografts were more frequently reported. The direct causes of low success rate of complete graft are imperfect temperature and sterilization condition for preserving bone flaps. Animal experiments were mainly to explore the bone resorption and osteogenesis mechanism of small and medium-sized animals. Little is reported on the simulation of delayed autologous skull formation after large-scale craniotomy. In the context of absorbing and nascent coexistence in all re-implanted bone grafts, there was always a gap between the bone flap and the bone window edge in patients undergoing phase I reduction in craniotomy. The authors found that the flat skull and the long bone of the extremities have different mechanisms in osteoinduction and bone conduction, and isolated bone flaps containing periosteum and dura mater should be preserved for creating optimal resuscitation conditions, like organ transplantation. This will be addressed in future work.

Key words: craniocerebral trauma, cranioplasty, skull autograft, bone flap transplantation, bone absorption, osteogenesis mechanism, clinical observation, animal experiments

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