Clinical Outcomes of 3D-Printed Bioresorbable Scaffolds for Bone Tissue Engineering—A Pilot Study on 126 Patients for Burrhole Covers in Subdural Hematoma

• Published in: Biomedicines Vol. 10; no. 11; p. 2702
• Main Authors: Toh, Emma M. S, Thenpandiyan, Ashiley A, Foo, Aaron S. C, Zhang, John J. Y, Lim, Mervyn J. R, Goh, Chun Peng, Dinesh, Nivedh, Vedicherla, Srujana V, Yang, Ming, Teo, Kejia, Yeo, Tseng Tsai, Nga, Vincent D. W
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 26.10.2022; MDPI
• Subjects: 3D printing; Anticoagulants; Biological products; Biomedical materials; bioresorbable; Blood; Brain; burrhole cover; Catheters; chronic subdural hemorrhage; Clinical outcomes; cosmetic outcomes; Design; Dura mater; FDA approval; Hematoma; Medical imaging; Medical records; Medical research; Medicine, Experimental; Meninges; Neurosurgery; Patients; Polycaprolactone; Properties; Quality of life; Review boards; Scalp; Skin; Tissue engineering; Transplants & implants; Singapore
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines10112702

Burrhole craniostomy is commonly performed for subdural hematoma (SDH) evacuation, but residual scalp depressions are often cosmetically suboptimal for patients. OsteoplugTM, a bioresorbable polycaprolactone burrhole cover, was introduced by the National University Hospital, Singapore, in 2006 to cover these defects, allowing osseous integration and vascular ingrowth. However, the cosmetic and safety outcomes of OsteoplugTM-C—the latest (2017) iteration, with a chamfered hole for subdural drains—remain unexplored. Data were collected from a single institution from April 2017 to March 2021. Patient-reported aesthetic outcomes (Aesthetic Numeric Analog (ANA)) and quality of life (EQ-5D-3L including Visual Analog Scale (VAS)) were assessed via telephone interviews. Clinical outcomes included SDH recurrence, postoperative infections, and drain complications. OsteoplugTM-C patients had significantly higher satisfaction and quality of life compared to those without a burrhole cover (ANA: 9 [7, 9] vs. 7 [5, 8], p = 0.019; VAS: 85 [75, 90] vs. 70 [50, 80], p = 0.021), and the absence of a burrhole cover was associated with poorer aesthetic outcomes after multivariable adjustment (adjusted OR: 4.55, 95% CI: 1.09–22.68, p = 0.047). No significant differences in other clinical outcomes were observed between OsteoplugTM-C, OsteoplugTM, or no burrhole cover. Our pilot study supports OsteoplugTM-C and its material polycaprolactone as suitable adjuncts to burrhole craniostomy, improving cosmetic outcomes while achieving comparable safety outcomes.