Autologous stem cells (adipose) and fibrin glue used to treat widespread traumatic calvarial defects: case report
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Autologous stem cells (adipose) and fibrin glue used to treat widespread traumatic calvarial defects: case report
Stefan Lendeckel1, , , Andreas Jödicke2, Petros Christophis2, Kathrin Heidinger3, Jan Wolff4, John K. Fraser5, Marc H. Hedrick5, Lars Berthold6 and Hans-Peter Howaldt1
1Department of Maxillofacial and Facial Plastic Surgery (Head: Prof. Dr. Dr. Hans-Peter Howaldt), Justus-Liebig-University Medical School, Giessen, Germany
2Department of Neurosurgery (Head: Prof. Dr. Dieter-Karsten Böker), Justus-Liebig-University Medical School, Giessen, Germany
3Department of Clinical Immunology and Transfusion Medicine (Head: Prof. Dr. Gregor Bein), Justus-Liebig-University Medical School, Giessen, Germany
4MacroPore Biosurgery Comp., Königstein, Germany
5Department of Surgery, Division of Plastic Surgery, University of California, Los Angeles, USA
6Department of Paediatric Radiology (Head: Prof. Dr. Gerhard Alzen), Justus-Liebig-University Medical School, Giessen, Germany
Received 28 October 2003; accepted 21 June 2004. Available online 28 October 2004.
Summary
This is a report of a 7-year-old girl suffering from widespread calvarial defects after severe head injury with multifragment calvarial fractures, decompressive craniectomy for refractory intracranial hypertension and replantation of cryopreserved skull fragments. Chronic infection resulted in an unstable skull with marked bony defects. Two years after the initial injury the calvarial defects were repaired. Due to the limited amount of autologous cancellous bone available from the iliac crest, autologous adipose derived stem cells were processed simultaneously and applied to the calvarial defects in a single operative procedure. The stem cells were kept in place using autologous fibrin glue. Mechanical fixation was achieved by two large, resorbable macroporous sheets acting as a soft tissue barrier at the same time. The postoperative course was uneventful and CT-scans showed new bone formation and near complete calvarial continuity three months after the reconstruction.
Keywords: Skull defects; Stem cells; Fibrin glue; Autologous bone graft
Dr. S. LENDECKEL, MD Department of Maxillofacial and Facial Plastic Surgery Justus-Liebeg-University Medical School Giessen 35385 Germany Tel.: +49 641 99 46271 Fax: +49 641 99 46279.
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Journal of Cranio-Maxillofacial Surgery
Volume 32, Issue 6 , December 2004, Pages 370-373 |
