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twtidwell

Autologous bone flap

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We store autologous bone flaps at our hospital in blood bank in a -70 tissue freezer. Yesterday an auto bone flap was sent to surgery to be reimplanted. After the surgeon implanted the bone flap, the patient began having active intractible seizures. The surgeon removed the bone flap and it was returned to the blood bank. The bone flap was placed back into the -70 tissue freezer. The bone flap was cultured per our hospital procedure both when initially collected and after being removed this time. We have never had an auto bone flap that has been thawed returned to be refrozen. We would appreciate anyones thoughts on this situation.

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I don't think a 'return" has never happened here. I would wonder if the surgeon would even consider using the flap again after the problem with the re-implantion. (Regardless of culture results or whatever.)

I would gather what research you can regarding regs (FDA?) and go to your pathologist with it. If you do not currently have a policy for re-issue, it would seem like you would have to get your pathologist to sign off on a re-release.

I would be interested in how you end up with this, as we may want to alter our own policy. Recently we threw away a flap at six months per our policy, and when a surgeon found out about it, he was pretty upset. (Throwing away the flap caused a flap.) Apparently he was still planning on using it. Now we have a notification system in place that allows the surgeon to designate whether or not to toss a flap when it expires.

Thanks, Scott

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