The Use of Tantalum for Repair of Cranial Defects in Infected Cases
The primary purpose of this article is to demonstrate that presence of a tantalum implant does not impair healing of an infected wound. Secondarily the author wishes to describe his experience with a hitherto untried method of dealing with abscess of the brain.
Tantalum, a newly available metal, has proved to be the most satisfactory material for repair of cranial defects.1–10 Thus far it has been employed chiefly in secondary repair of cranial defects resulting from war wounds. A few surgeons have advocated its use in contaminated wounds, as in immediate repair of compound comminuated fractures of the skull.11,12,13,14 Infection, however, has been generally considered an absolute contraindication to the use of any metal implant.
Treatment of brain abscess by complete excision rather than drainage has yielded a lower morbidity in the author’s experience, but the danger of cerebral fungus following radical excision has been a deterrent to the universal application of this method. Since cerebral fungus can be entirely prevented by closure of the skull defect with tantalum, the use of this material naturally suggested itself. Furthermore, tantalum has proved so inert by past experience13 that its use in infected cases seemed entirely justifiable. In the past twenty months, therefore, tantalum has been used in 7 instances for closure of cranial defects resulting from excision of brain abscesses and in 1 case of acute osteomyelitis of the frontal bone. In this series there were six recoveries and two deaths. In 6 of the cases the wound healed by. . .