Features of Cranial Bone Reconstruction in Patients at Various Stages of Rehabilitation
- Authors: Varyukhina M.D.1, Vorobyev A.N.1, Levin D.V.1, Ilyina A.A.2, Kolesov D.L.2, Shaybak A.A.2, Radutnaya M.L.2, Yakovlev A.А.2, Gorelova E.S.3
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Affiliations:
- Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
- The Russian National Research Medical University named after N.I. Pirogov
- Issue: Vol 4, No 2 (2022)
- Pages: 83-89
- Section: ORIGINAL STUDY ARTICLE
- URL: https://bakhtiniada.ru/2658-6843/article/view/108760
- DOI: https://doi.org/10.36425/rehab108760
- ID: 108760
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Abstract
Background: Postoperative skull bone defects are one of the urgent problems of neurorehabilitation. Skull bone defect limits the scope of rehabilitation measures, complicates patient care, and leads to secondary complications. Significant risks of postop complications demands making a decision about surgery individually. Surgery timing varies widely and remains controversal. Aims: to formulate the features of skull bone defects reconstruction in patients at various stages of rehabilitation based on the analysis of the frequency and structure of postoperative surgical complications. Materials and methods: The retrospective analysis of cranioplasty results was performed in the 129 patients treated in Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology from 2018 to 2022 at various stages of rehabilitation (intensive care, inpatient, outpatient). The features of surgery, frequency and structure of surgical complications dependent on rehabilitation stage were analyzed. Results: A total of 129 patients were included in the study: 84 men (65%) and 45 women (35%). The average age of the patients was 43.2±13.9 years. The average timing of cranioplasty surgery was 79 days [IQR 60; 133]. Seventy two patients (56%) were operated on at the intensive care stage of rehabilitation, forty (31%) and seventeen (13%) patients were operated on at the inpatient and outpatient stages, respectively. In total, complications occurred in 16 patients (12%). Intensive care patients required careful preoperative preparation, correction of homeostasis and metabolism disorders. In our series, postoperative complications were observed in 12 patients on intensive care stage (17%); all cases of hydrocephalus occurred only in intensive care patients. In patients operated on at the inpatient stage of rehabilitation, complications occurred in 4 cases (10%), while there was no statistically significant difference in the incidence of complications in patients from the intensive care and inpatient subgroups (p=0.334). Complications in patients at the outpatient stage of rehabilitation were not observed in our series. Conclusions: Cranioplasty surgery is possible even in somatically burdened patients at the intensive care stage of rehabilitation. It allows to expand the scope of rehabilitation measures and facilitate medical care. When planning surgical intervention in the early stages after the cranioplasty surgery, it is important to take into account the increased risk of hydrocephalus manifestation.
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##article.viewOnOriginalSite##About the authors
Maria D. Varyukhina
Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: mvaryuhina@fnkcrr.ru
ORCID iD: 0000-0001-8870-7649
SPIN-code: 7463-4645
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionAlexey N. Vorobyev
Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: avorobyev@fnkcrr.ru
ORCID iD: 0000-0003-3742-6171
SPIN-code: 3253-7996
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionDmirty V. Levin
Federal Scientific and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: dlevin@fnkcrr.ru
SPIN-code: 2930-4424
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionAnna A. Ilyina
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: shishova-1992@mail.ru
ORCID iD: 0000-0001-6188-870X
SPIN-code: 1200-3966
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionDmitry L. Kolesov
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: dimoz@yandex.ru
ORCID iD: 0000-0002-8450-5211
SPIN-code: 1016-1374
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionAlexandr A. Shaybak
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: shaybak@mail.ru
ORCID iD: 0000-0003-0087-1466
SPIN-code: 8544-5407
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionMargarita L. Radutnaya
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: mradutnaya@fnkcrr.ru
ORCID iD: 0000-0002-9181-2295
MD
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionAlexey А. Yakovlev
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology
Email: ayakovlev@fnkcrr.ru
ORCID iD: 0000-0002-8482-1249
SPIN-code: 2783-9692
MD, Cand. Sci. (Med.)
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow regionElena S. Gorelova
The Russian National Research Medical University named after N.I. Pirogov
Author for correspondence.
Email: esgorelova@bk.ru
ORCID iD: 0000-0002-5152-6681
Russian Federation, 141534, 777, Building 1, Lytkino, Moscow region
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