Iqbal Ahmad, Sajjad Ahmad, Samia Saeed.
Primary Titanium Mesh Cranioplasty in Open Depressed Skull Fractures.
Pak J Neuro Surg Jan ;20(1):33-6.

Objectives: Primary reconstruction of open fracture with titanium mesh should be attempted as and when possible because it is feasible, safe, and cosmetically preferable than the conventional staged approach. The aim of the study was to analyze, the benefits of Primary reconstruction of open fracture with titanium mesh than the conventional staged approach.Materials and Methods: We used a primary single – stage reconstruction for patients presenting with open depressed skull fractures. All patients received antibiotic prophylaxis. The patients underwent elevation of the compound fracture and craniotomy if necessary. Debridement was performed, followed by skull reconstruction using a 0.6-mm titanium mesh.Results: We present 14 consecutive 10 (71%) male, 4 (29%) female patients (age b/w 11 to 45 years) who underwent primary reconstruction of open depressed skull fractures from May 2014 to September 2015, were analyzed retrospectively. Clinical and radiologic follow-up was performed one and half year after surgery. The duration of the surgery was 2 to 3 hours. No evidence of adverse healing, wound infection, or implant exposure or extrusion in any of the patients reviewed in our series. Cosmetic deformity correction to excellent level was achieved in better way as compared to contralateral site. Conclusions: Primary reconstruction of open fracture with titanium mesh should be attempted as and when possible because it is feasible, safe, and cosmetically preferable than the conventional staged approach. Further technological advance and larger studies are required to investigate the usefulness of titanium mesh devices in neurosurgery and to obtain long-term good results.

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