gms | German Medical Science

Objective: Cranioplasty plays a crucial role to restore the integrity of the skull, to protect the brain, to avoid disappointing cosmetic outcome and to prevent the sinking skin flap syndrome. Although cranioplasty is thought to be a standard neurosurgical procedure it is performed largely different depending on conventions in each neurosurgical unit. Wound healing disorders, intracranial bleedings, new neurological deficits and biological compatibility of the cranioplastic material are well known complications. While appropriate studies on cranioplasties are not available at present, profound data collection is the overarching principle of the GCRR to finally improve the clinical course of these patients.

Method: The GCRR is a project initiated by a consortium of individual members of the Section for Neurotrauma and Intensive Care in Neurosurgery of the Deutsche Gesellschaft für Neurochirurgie (DGNC). Every neurosurgical unit in Germany conducting cranioplasties is/will be invited to join the registry. This prospective multicenter database will focus on patients who received decompressive craniectomy and subsequent cranioplasty. A database will be set up in which each patient will be included anonymously. A substantial questionnaire has been developed and will be provided to all participating units. Patient specific risk factors, surgical details, materials for cranioplasty and intra- and postoperative complications will be recorded. The investigation period will cover acute complications as well as subsequent problems (e.g. aseptic bone necrosis) and long-term outcome. Data collection and submission will be performed locally. Central processing of anonymised questionnaires will be operated under the responsible surveillance of the consortium. Data-ownership or data interpretation will remain exclusively to the consortium and participating centers. All results of the GCRR including epidemiological data, surgical techniques, material for cranioplasty, complications, risk factors and long-term outcome will be published and/or reported at forthcoming meetings of the DGNC.

Results: The structural details of the GCRR and the prospective questionnaire are presented to open up data acquisition and to encourage any interested institution to participate on the registry.

Conclusions: Registry design and number of participating centers will secure a high quality of data which will allow to review our current clinical practice and to serve as a base for guidelines in cranioplastic surgery.