Paige klem Or consortium 2019 The Basics What does autologous mean Cells or tissues obtained from the same individual Reason for a skull flap Craniectomy Surgical removal of a portion of the skull ID: 774738
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Skull flaps: autologous tissue
Paige klem. Or consortium 2019
Slide2The Basics
What does autologous mean? Cells or tissues obtained from the same individualReason for a skull flap? Craniectomy: Surgical removal of a portion of the skull.Relieve pressure on the brain Due to bleeding or swelling Trauma Stroke Typically drains placed Video: https://www.youtube.com/watch?v=BaAASQotNhk
Slide3Removal of skull flap
After the procedure is done (evacuating a clot) the brain will continue to swell To allow the brain to swell upward rather than downward (compressing the brainstem) If there is infection, the bone flap may be discarded Also depending on the type of trauma (shattered or broken) Note: The brain may not immediately swell, or the swelling may be minimal which results in the flap being replaced after the surgery and then the patient coming back to have the flap removed.
Slide4Storage of bone flap options
Freezer Abdominal Pocket flap:A pocket is made in the subcutaneous tissue of the patients abdomenIt is protected by the fatty tissue of the patient Pros and Cons? Higher risk of infection with pocket flap
Slide5guideline: Autologous cranial bone flaps
May be frozen or cryopreserved, at −4° F (-20° C) or colder for six months or less.Autologous bone may be stored at −40° F (-40° C) or colder for up to five years with verification that the facility has registered with FDA as a tissue establishment, or verification that registration as a tissue establishment is not required.May be stored in a subcutaneous pocket within the patient in a location determined by the physician, andWill not be subjected to the steam sterilization process unlessthere is a clinical indication to do so (eg, to destroy tumor cells) andthe facility has registered with US Food and Drug Administration as a tissue establishment.
Slide6Temperature monitoring of fridge/freezer
Provide continuous temperature monitoring and should be monitored regularly with daily temperature checks recorded;Have an alert or alarm system that notifies personnel when the temperature is not within the acceptable range; andHave an emergency power system.The alert or alarm should sound in an area where an individual is present at all times to initiate corrective action or notify personnel who are available to respond. Processes should be established for maintaining the temperature and integrity of stored autologous tissue in the event of a refrigerator or freezer malfunction and for responding to a malfunction of the refrigerator or freezer that occurs when the facility is closed or when the area where the tissue is stored is unoccupied.
Slide7Replacement of bone flap
Typically 2-3 months after craniectomy Dependent upon patient disease process Concerns: Bone resportion Can be avoided if replantation is in less than 6 months Infection
Slide8What does your policy say?
Find your hospital policyHow do you label this? What do you document? Where is your freezer?