{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T12:02:34Z","timestamp":1780660954356,"version":"3.54.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020205","name":"Health Commission of Jiangxi Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020205","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Safely and efficiently separating myocutaneous flaps that are densely adherent to the dura mater remains a critical challenge in cranioplasty. Traditional dissection methods and prophylactic implantation of anti-adhesion materials both have limitations. This study aims to propose and validate a \u201cTissue Biophysics-Based Myocutaneous Flap Dissection Strategy.\u201d By systematically analyzing the biophysical properties of different tissue interfaces and dynamically matching the optimal dissection instruments and techniques, we seek to optimize surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed the clinical data of 124 patients who underwent frontotemporal cranioplasty at our institution between January 2020 and September 2025. Patients were divided into a new strategy group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955) and a conventional group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200969). The new strategy group employed blunt mechanical expansion techniques based on the loose subgaleal plane and low-power selective electrothermal dissection techniques based on the impedance difference between the temporalis muscle and the dura mater. The conventional group received standard dissection methods. We compared operative time, intraoperative blood loss, dural tear rate, postoperative drainage, and complication rates between the two groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The new strategy group demonstrated significantly lower intraoperative blood loss (128.18\u2009\u00b1\u200945.32\u2005mL vs. 276.81\u2009\u00b1\u200968.54\u2005mL,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), shorter operative time (110.55\u2009\u00b1\u200918.27\u2005min vs. 162.32\u2009\u00b1\u200922.65\u2005min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), and a reduced dural tear rate (12.7% vs. 39.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) compared to the conventional group. The incidence of postoperative epidural hematoma was also significantly lower in the new strategy group (10.9% vs. 30.4%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). No statistically significant differences were found in the rates of other complications such as infection or epilepsy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The proposed \u201cTissue Biophysics-Based Myocutaneous Flap Dissection Strategy\u201d integrates tissue biophysical principles (e.g., interfacial compliance, electrical impedance differences) into surgical decision-making, aiming to provide a practical surgical strategy. This surgical strategy appears to enhance the safety and efficiency of cranioplasty while reducing the risk of key complications in this patient cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1794362","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:11:46Z","timestamp":1780657906000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Precision dissection strategy for myocutaneous flap in frontotemporal cranioplasty based on tissue biophysical properties"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"PingGen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. Y.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. F.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z. G.","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. J.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. X.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. H.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. B.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yichun People\u2019s Hospital","place":["Yichun, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1007\/s11910-021-01147-6","article-title":"Cranioplasty following severe traumatic brain injury: role in neurorecovery","volume":"21","author":"Ozoner","year":"2021","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/s12893-025-02943-4","article-title":"Early cranioplasty versus traditional cranioplasty enhances surgical outcomes in patients with malignant cerebral infarction after decompressive craniectomy","volume":"25","author":"Yan","year":"2025","journal-title":"BMC Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"204","DOI":"10.25259\/SNI_1003_2023","article-title":"Neurocognitive outcome post cranioplasty: the role of cerebral hemodynamics and cerebrospinal fluid dynamics","volume":"15","author":"Agrawal","year":"2024","journal-title":"Surg Neurol Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1007\/s10143-025-03462-9","article-title":"Potential techniques to facilitate dissection in patients undergoing cranioplasty following decompressive craniectomy","volume":"48","author":"Azab","year":"2025","journal-title":"Neurosurg Rev"},{"key":"B5","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1227\/ons.0000000000001063","article-title":"Two-Stage anatomic myocutaneous flap dissection in cranioplasty: technical nuances and single-surgeon experience","volume":"26","author":"Sorek","year":"2024","journal-title":"Oper Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"101","DOI":"10.13004\/kjnt.2024.20.e22","article-title":"Unseparated temporal muscle and duramater cranioplasty methods following decompressive craniectomy: technical note","volume":"20","author":"Tobing","year":"2024","journal-title":"Korean J Neurotrauma"},{"key":"B7","doi-asserted-by":"publisher","first-page":"124","DOI":"10.3390\/brainsci11010124","article-title":"Clinical efficacy and safety of silicone elastomer sheet during decompressive craniectomy: anti-adhesive role in cranioplasty","volume":"11","author":"Kim","year":"2021","journal-title":"Brain Sci"},{"key":"B8","doi-asserted-by":"publisher","first-page":"360","DOI":"10.3340\/jkns.2024.0176","article-title":"Efficacy of anti-adhesive substitute and step-by-step techniques in decompressive craniectomy and subsequent cranioplasty","volume":"68","author":"Kim","year":"2025","journal-title":"J Korean Neurosurg Soc"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e585","DOI":"10.1016\/j.wneu.2023.01.089","article-title":"Extensive foreign body reaction to synthetic dural replacement after decompressive craniectomy with radiological and histopathology evidence: observational case series","volume":"172","author":"Mohammed","year":"2023","journal-title":"World Neurosurg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.5999\/aps.2014.41.4.362","article-title":"Safety of silastic sheet for orbital wall reconstruction","volume":"41","author":"Moon","year":"2014","journal-title":"Arch. 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