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Risk Factors of Titanium Mesh Exposure: Experience from a Tertiary Referral Center

  • Christian Beta Kurniawan ,
  • Akhmad Imron ,
  • Muhammad Rainda Farhan ,


Introduction: Titanium mesh is commonly used to reconstruct the cranium in cranioplasty procedure. Although it is generally well-tolerated, erosion of the overlying soft tissue due to the implant exposure remained as a major risk that could impair patients' outcome. This study aimed to investigate the potential risk factors of titanium mesh exposure.

Methods: Medical records from patients who underwent titanium mesh cranioplasty within the period of July 2016 to July 2020 were retrieved. Patients' demographic and characteristics were reviewed to investigate the potential risk factors in titanium mesh exposure.

Results: Twenty-three patients were included in this study with the mean age of 44.6 (+10.9) years. Fourteen patients (60.9%) acquired titanium mesh exposure in less than 6 months after cranioplasty surgery. In majority, the duration of surgery were more than 3 hours (65.2%). Intraoperative blood loss volume was less than 500 cc in 8 patients (34.8%), 500-1000 cc in 8 patients (34.8%), and more than 1000 cc in 7 patients (30.4%). Nineteen patients had bone defect of >10 cm and the indications for craniectomy were tumor resection in 56.5% patients, followed by infection in 17.4%. The sign of infection was present in 12 patients (52.2%). Only 2 patients (8.7%) had radiotherapy after cranioplasty. One patient was diagnosed with polycythemia vera.

Conclusion: Titanium mesh exposure following cranioplasty surgery is a complication that might affect the patients' overall outcome. Female predominance, long surgery duration, excessive intraoperative blood loss might be correlated with higher risk of titanium mesh exposure.


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How to Cite

Kurniawan, C. B., Akhmad Imron, & Muhammad Rainda Farhan. (2022). Risk Factors of Titanium Mesh Exposure: Experience from a Tertiary Referral Center. Bali Medical Journal, 11(3), 1436–1440.




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Christian Beta Kurniawan
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BMJ Journal

Akhmad Imron
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BMJ Journal

Muhammad Rainda Farhan
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BMJ Journal