Cranial Bone Flap Falls to the Floor During a Craniotomy

  1. Hi Everyone!

    My teacher just posted a discussion topic online that asks what would be the correct procedure of sterilization should a bone flap fall to the floor during a craniotomy? I did some research online and came across this website and while it is helpful it's always hard to tell if it's really truthful. Here is the site:

    So I just thought I would post the topic in here to see if any of you had this particular thing happen and how you approached it?

    This is just for discussion purposes only. It's not homework or a paper or anything and is a voluntary discussion as well.
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    About gymnut

    Joined: Aug '10; Posts: 254; Likes: 391
    Oncology Tech; from US


  3. by   Rose_Queen
    Had it happen once with a flap that we were going to bank and put it back in later. We autoclaved it, which caused it to fracture, which the surgeon said was because it had already had a hairline fracture. Then we packed it up and sent it to be frozen. Got soaked in bacitracin before it got put back in too. Different type of situation but along the same lines: surgeon harvested saphenous vein for fem pop. Surg tech let suction tip get a little too close. Circulator had to dig vein out of the filter in the suction port. Vein soaked in bacitracin and used for bypass. Don't think the patient ended up with an infection either.
  4. by   OCNRN63
    Five second rule!
  5. by   gymnut
    Quote from OCNRN63
    Five second rule!
    Oh if only the 5 second really worked in the OR!!
  6. by   ChristineAdrianaRN
    Quote from OCNRN63
    Five second rule!
    LOL! If only!

    Hasn't happened where I work, but at the hospital across the street its apparently happened, and they also did the flash sterilizaition/Baci soaking thing.
  7. by   sapphire18
    Don't really have anything helpful to add to the discussion, other than this exact thing happened in a surgery I was observing as a new-grad. World-class neurosurgeon at one of the best hospitals in the world. Oops...

    They actually ended up putting a plate in once her swelling went down (weeks later).
  8. by   Rose_Queen
    Quote from gymnut
    Oh if only the 5 second really worked in the OR!!
    Yeah, just think of how much less running for supplies we'd have to do, and there would be no angry surgeons because that single instrument that we don't have a backup for fell on the floor!
  9. by   ORTRAV
    I have seen this happen a few times. Once a methylmethracrolate flap was fashioned. The other times we just soaked the flap in betadine prior to putting it back on.