NYMC Faculty Publications

Decompressive Craniectomy with Scalp Expansion Graft Using a Temporary Synthetic Skin Substitute in the Pediatric Population: Case Series and Review of the Literature

DOI

10.1007/s00381-019-04494-5

Journal Title

Child's Nervous System : ChNS : official journal of the International Society for Pediatric Neurosurgery

First Page

1319

Last Page

1324

Document Type

Review Article

Publication Date

6-2020

Department

Neurosurgery

Abstract

INTRODUCTION: The use of decompressive craniectomy in children is controversial and often reserved for patients with refractory intracranial hypertension. Following decompression, skin closure in select cases can be challenging due to brain herniation and swelling through the craniectomy defect. In these cases, partial cortical debridement is sometimes performed.

METHODS: We describe two cases in which a synthetic skin substitute was used to facilitate a tension-free closure, rather than performing a partial lobectomy.

RESULTS: At 6-month follow-up, both patients are at preoperative cognitive baseline, with some residual hemiparesis.

DISCUSSION: We believe that use of a synthetic skin substitute for skin closure after decompression is a suitable option for closure of traumatic scalp wounds and may contribute to improved functional outcome in patients with severe intraoperative brain swelling.

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