Traumatic brain injury (TBI) is a common neurosurgical presentation, with a variable clinical phenotype depending on the severity and anatomy of injury [1, 2]. A proportion of TBI patients develop uncontrollable raised intracranial pressure (ICP). In this group, an increasingly common surgical management option is decompressive craniectomy (DC), involving the removal of a bone flap to allow the brain to swell while relieving ICP [3, 4]. The removed flap may be stored in an abdominal pouch or a specialised refrigeration unit, or discarded depending on factors such as infection and surgeon preference [5,6].

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