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Title: Titanium Mesh versus Autologous Bone Graft Cranioplasty
Authors: Babar Shamim, Awais Ali Khan, Muhammad Junaid Mushtaq, Amjad Saeed Abbassi, Ali Ahmed, Maria Shahzadi
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2023
Volume: 73
Issue: Supplementary 1
Language: English
DOI: 10.51253/pafmj.v73iSUPPL-1.3467
Keywords: CranioplastyAbscess formationAutologous bone graftPost-op painSeroma formationtitanium mesh
Objective: To compare the efficacy of titanium mesh to autologous bone grafting in cranioplasty and assessing complications like seroma and abscess formations and subjective measures of pain. Study Design: Comparative cross-sectional study
Place and Duration of Study: Neurosurgery Department, Combined Military Hospital, Rawalpindi Pakistan from Aug 2017 to Dec 2018.
Methodology: Twenty patients (Women=12, Men=8) were randomly assigned to Titanium Mesh (TM) group and 20 patients(Women=7, Men=13) to Autologous Bone Graft (ABG) group. All were subjected to cranioplasty using Titenium Mesh andAutologous Bone Graft procedures to assess cranial seroma and abscess formation and pain.Results: Comparison of pain on day 3 showed 7(35%) patients in titenium mesh group experienced pain compared to 14(70%)patients in the autologous bone graft group, which was statistically significant (p<0.001). Similarly, a comparison on day 7,revealed that pain in the titenium mesh group reduced to 5(25%) patients compared to 11(55%) patients in the autologous bonegraft group, which again was statistically significant (p<0.001). Four(20%) patients in titenium mesh group and 7(35%) patients in autologous bone graft group developed seroma on day 3 and the difference was significant (p<0.001). Two(10%) patients in titenium mesh group and 5(25%) patients in autologous bone graft group developed abscess, which was significantly different (p<0.001).Conclusion: Cranioplasty using titenium mesh is better than autologous bone graft because complications like seroma, abscess and pain are attenuated in surgical cohorts.
To compare the efficacy of titanium mesh to autologous bone grafting in cranioplasty and assess complications like seroma and abscess formations and subjective measures of pain.
Comparative cross-sectional study conducted at the Department of Neurosurgery, Combined Military Hospital, Rawalpindi Pakistan, from August 2017 to December 2018. Forty patients (20 in Titanium Mesh group, 20 in Autologous Bone Graft group) aged 20-60 years who received craniotomy for Traumatic Brain Injury were included. Patients with chronic diseases were excluded. Cranioplasty was performed using Titanium Mesh or Autologous Bone Graft. Post-operative pain was assessed using a visual analogue scale on days 3 and 7. Seroma was assessed on day 3, and abscess on day 5. Data was analyzed using SPSS version 14.0, with Chi-square test for categorical variables.
graph TD;
A["Patient Recruitment TBI patients, 20-60 years"] --> B["Random Assignment"];
B --> C["Titanium Mesh Group n=20"];
B --> D["Autologous Bone Graft Group n=20"];
C --> E["Cranioplasty with Titanium Mesh"];
D --> F["Cranioplasty with Autologous Bone Graft"];
E --> G["Post-op Assessment Pain, Seroma, Abscess"];
F --> G;
G --> H["Data Analysis SPSS, Chi-square test"];
H --> I["Conclusion"];
Cranioplasty is a high-risk procedure with significant complication rates. The study suggests that titanium mesh is superior to autologous bone grafting in reducing post-operative complications such as pain, seroma, and abscess formation. This could lead to a decreased burden on the health budget by lowering complication rates.
Titanium mesh group showed statistically significant lower rates of pain on day 3 (35% vs 70%, p<0.001) and day 7 (25% vs 55%, p<0.001) compared to the autologous bone graft group. Seroma formation was significantly lower in the titanium mesh group (20% vs 35%, p<0.001), as was abscess formation (10% vs 25%, p<0.001).
Cranioplasty using titanium mesh is better than autologous bone graft because complications like seroma, abscess, and pain are attenuated in surgical cohorts.
- The study included 40 patients, randomly assigned to two groups of 20 each.
- Pain was assessed on day 3 and day 7 post-operatively.
- Seroma formation was assessed on day 3 post-operatively.
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