Formosan Journal of Surgery

LETTER TO THE EDITOR
Year
: 2020  |  Volume : 53  |  Issue : 2  |  Page : 78--80

Closing of postoperative integument, skull bones, and dura defects


Fachreza Aryo Damara 
 Department of Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Jawa Barat, Indonesia

Correspondence Address:
Dr. Fachreza Aryo Damara
Sederhana St 39th Sukajadi, Bandung, West Java
Indonesia




How to cite this article:
Damara FA. Closing of postoperative integument, skull bones, and dura defects.Formos J Surg 2020;53:78-80


How to cite this URL:
Damara FA. Closing of postoperative integument, skull bones, and dura defects. Formos J Surg [serial online] 2020 [cited 2020 Jul 2 ];53:78-80
Available from: http://www.e-fjs.org/text.asp?2020/53/2/78/283127


Full Text



Dear Editor,

We have read the case report entitled, “Closing of postoperative integument, skull bones and dura defects” by Lin et al. published in Formosan Journal of Surgery (2019;52:63-5).[1] We want to congratulate the authors for successful case and contribution.

Based on the case history, the authors mentioned that the patient had ischemic stroke of right hemisphere on the postoperative period that leads to symptomatic conditions as having oppression of consciousness to coma. The ischemic stroke of the patient could be the manifestation of hypercoagulation state, where the patient might possibly have postoperative thrombocytosis. Based on the literature, thrombocytosis often found incidentally in 30%–50% of cases.[2] Most of the cases were due to body reactive response after surgicals. The reactive response or secondary thrombocytosis was elicited as increasing in pro-inflammatory cytokines, such as interleukin (IL)-1, IL-6, and IL-11, and can be evaluated by assessing patient platelet count.[3] As the blood laboratory findings were not provided on the case, we assume that the authors ought to take consideration to discuss the cause of postoperative complication of ischemic stroke. Providing the platelet counts result of the patient might add our concern that hypercoagulation state is possibly play a role in the etiologic cause of ischemic stroke. Although the study that discussed postoperative thrombocytosis was on colorectal surgery, we assume that the authors' case was confidently matched to discuss the first evidence of postoperative thrombocytosis in neurosurgical procedure. Hence, given information on postoperative laboratory results could enhance physicians' or surgeons' awareness of postoperative thrombocytosis complication.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Lin J, Sobakar E, Ivanov O, Semichev E. Closing of postoperative integument, skull bones and dura defects. Formos J Surg 2019;52:63-5.
2Madaan GB, Jairajpuri ZS, Hajini FF, Jetley S. Postoperative thrombocytosis: An unusual case report. Int J Appl Basic Med Res 2015;5:225-7.
3Mohamud M, Osborne L, Jones HG, Ahmed A, Beynon J, Harris DA, et al. Thrombocytosis as a marker for postoperative complications in colorectal surgery. Gastroenterol Res Pract 2018;2018:1978639.