The application of two flap dissection methods in the standard large decompressive craniectomy / 中国医师杂志

ABSTRACT

Objective:To compare the application effect of electrotome flap separation and neuro dissector in standard large decompressive craniectomy (SLDC).Methods:From January 2020 to December 2020, 40 patients with severe craniocerebral injury who met the standard and planned to undergo SLDC were randomly divided into two groups 20 patients in the electrotome separation group and 20 patients in the nerve dissector group. The time of flap seperation, the degree of edema and atrophy of temporal muscle on the operation side were compared between the two groups.Results:There was no significant difference in the time of flap separation between the two groups [(20.91±12.33)min vs (29.92±12.69)min, t=1.799, P>0.05]. The patients in the two groups had different degrees of temporal muscle edema 48 hours after operation. The degree of temporal muscle edema in the electrotome separation group was more serious than that in the nerve dissector group [(18.82±5.23)cm 3 vs (10.71±3.69)cm 3,t=7.314, P<0.05]. The degree of temporal muscle atrophy in the electrotome separation group was higher than that in the nerve dissector group [(8.26±2.38)cm 3 vs (6.72±2.13)cm 3,t=2.314, P<0.05]. Conclusions:In SLDC surgery, there was no significant difference in flap separation time between electrotome separation flap method and neuro dissector flap separation method, but the latter had less damage to temporal muscle and less atrophy of temporal muscle after operation.