Challenging frontiers in neuroplastic cranial reconstruction: addressing neurosurgical wound healing complications through interdisciplinary collaboration – an observational study

• DOI: 10.1007/s00701-024-06328-z
• Publication Date: 2024-10-30T14:02:12Z
• Authors: Kathrin M. Aufsch...; Harald Stefanits; Tobias Rossmann; Martin Aichholzer; Wolfgang Senker; Philip Rauch; Helga Wagner; Philipp Hermann; Matthias Gmeiner; Andreas Gruber; Manfred Schmidt
• Keywords: Wound dehiscence

Abstract Background and objectives Although rare, complications like skin dehiscence necrosis after neurosurgery pose significant challenges by increasing the risk of infections spreading to epidural, subdural, or intracerebral spaces. This retrospective, single-center study aims assess prior clinical courses, neuroplastic repair, outcomes patients with defects following cranial neurosurgical procedures, outline our interdisciplinary reconstructive protocol. Methods A retrospective analysis was performed on surgeries conducted at Department Neurosurgery, spanning from 2017 2023. Patients requiring combined expertise plastic surgery for effective treatment were included. The sizes measured using intraoperative photographs analyzed freeware ImageJ software, version 2018. All provided informed consent surgeries. If not possible due neurological deterioration, sought adult representatives next kin except acute circumstances. admitted hospital agree pseudonymized use their medical data tissue specimens research purposes in contract. Results cohort 24 experiencing wound healing procedures underwent a total 29 reconstruction skin, dural, bone defects. After surgery, 8 out (33.3%) developed surgical complications, 6 these revision persistent infection. In all cases, permanent closure successfully achieved adherence proposed algorithm. Conclusions Our underscores necessity an integrated approach effectively manage single stage surgery. Key interventions include differentiation between gaping lesions, alongside precise management issues cerebrospinal fluid fistulas hydrocephalus. Plastic assessing possibilities limitations both local free flap is essential.