Effectiveness and Safety of Pressure Dressings on Reducing Subdural Effusion After Decompressive Craniectomy

Application of a 3D-Printed Personalized Cranial Defect Flap Support Device in the Treatment of Severe Ipsilateral Subgaleal Effusion Following Decompressive Craniectomy: A Technical Note

This technical note introduces the application of a 3D-printed personalized cranial defect flap support device for the treatment of severe ipsilateral subgaleal effusion (SISE) after decompressive craniectomy (DC). By closely fitting this device to the cranial defect, significant improvements were observed, including the resolution of subgaleal effusion, restoration of midline structures, and facilitation of neurological recovery. This report provides a detailed description of the design and manufacturing process of the device and highlights its therapeutic effects through comparative CT imaging of a representative patient. These findings underscore the potential of this innovative device in enhancing postoperative management of SISE.

Ultrasound-Guided Percutaneous Puncture Combined With Continuous Pressure Dressing for Treating Subcutaneous Fluid Accumulation in the Bone Window Area After Decompressive Craniectomy

Subcutaneous fluid accumulation in the bone window area is a common complication after decompressive craniectomy. If not promptly addressed, it may progress to serious complications such as intracranial infection and hydrocephalus, significantly affecting treatment outcomes and prognosis. However, there is currently no standardized approach for managing subcutaneous fluid accumulation. Ultrasound-guided percutaneous puncture in the bone window area can directly decrease the accumulated fluid; moreover, when combined with continuous pressure dressing, this approach can effectively eliminate subcutaneous fluid in a short period, prevent severe complications, and enhance patient recovery outcomes.

Safety and efficacy of a 3D-printed external cranial protection device in preventing complications after unilateral supratentorial decompressive craniectomy: A retrospective cohort study

The objective was to clarify the feasibility and clinical effect of 3D-printed external cranial protection devices (ECPD) in preventing complications following unilateral supratentorial decompressive craniectomy (DC). A retrospective cohort study was conducted on post-DC patients meeting inclusion and exclusion criteria. In the experimental group, head computed tomography data were collected after DC, and the ECPD were 3D-printed with photosensitive resin materials, and fixed to the bone window defect for continuous wear. The control group received similar postoperative treatment and procedures but did not place the ECPD. Clinical data were collected and analyzed. Forty-four patients were enrolled, 24 in the experimental and 20 in the control group. The incidence of postoperative complications of DC was 84.09%. The median time to initial use of the 3D-printed ECPD was 13.5 days. No patients had skin pressure ulcers, allergies, or wound infections. There were no statistically significant differences between the groups in pre-DC Glasgow Coma Scale scores, post-DC complication rates, or Glasgow Outcome Scale scores at discharge (P > .05). Whereas, there was a statistically significant difference in pre-cranioplasty DC-related complications (P = .027), with a notable reduction in the incidence of subdural effusion in the experimental group (P = .004). The 2 groups had no significant differences in modified Rankin Scale scores after cranioplasty. The clinical use of the 3D-printed ECPD is safe and reliable, effectively reducing the incidence of complications following DC, particularly in the prevention and treatment of subdural effusion. However, it does not significantly improve the prognosis of patients after DC, warranting further research.