Safety and efficacy of a 3D-printed external cranial protection device in preventing complications after unilateral supratentorial decompressive craniectomy: A retrospective cohort study

The objective was to clarify the feasibility and clinical effect of 3D-printed external cranial protection devices (ECPD) in preventing complications following unilateral supratentorial decompressive craniectomy (DC). A retrospective cohort study was conducted on post-DC patients meeting inclusion and exclusion criteria. In the experimental group, head computed tomography data were collected after DC, and the ECPD were 3D-printed with photosensitive resin materials, and fixed to the bone window defect for continuous wear. The control group received similar postoperative treatment and procedures but did not place the ECPD. Clinical data were collected and analyzed. Forty-four patients were enrolled, 24 in the experimental and 20 in the control group. The incidence of postoperative complications of DC was 84.09%. The median time to initial use of the 3D-printed ECPD was 13.5 days. No patients had skin pressure ulcers, allergies, or wound infections. There were no statistically significant differences between the groups in pre-DC Glasgow Coma Scale scores, post-DC complication rates, or Glasgow Outcome Scale scores at discharge (P > .05). Whereas, there was a statistically significant difference in pre-cranioplasty DC-related complications (P = .027), with a notable reduction in the incidence of subdural effusion in the experimental group (P = .004). The 2 groups had no significant differences in modified Rankin Scale scores after cranioplasty. The clinical use of the 3D-printed ECPD is safe and reliable, effectively reducing the incidence of complications following DC, particularly in the prevention and treatment of subdural effusion. However, it does not significantly improve the prognosis of patients after DC, warranting further research.