TY - JOUR
T1 - Galea-pericranium dural closure: Can we safely avoid sealants?
AU - Giovanni, Sabatino
AU - Della Pepa, Giuseppe Maria
AU - La Rocca, Giuseppe
AU - Lofrese, Giorgio
AU - Albanese, Alessio
AU - Maria, Giulio
AU - Marchese, Enrico
PY - 2014
Y1 - 2014
N2 - Objective Dural closure is one of the most critical steps in neurosurgical procedures as it prevents many common postoperative complications. Methods of dural closure include the use of allogenic, autogenic, xenogenic, absorbable or synthetic materials together with sealant/glues or hemostatic compounds. Most common autogenic graft is galea-pericranium. This study aims to demonstrate how the intrinsic properties of the galea-pericranium make effectively useless the application of any glue in order to ensure the watertight integrity of the graft. Patients and methods 276 cases were included in the study. Postoperative dural-closure related complication in patients subjected to duraplasty were analysed in three groups undergoing different duraplasty techniques: galea-pericranium graft without sealants, galea-pericranium graft plus sealant, non-autologous dural patch plus sealant. Results No statistically significant differences between the three groups were observed in terms of subcutaneous fluid collection rate, CSF fistulas, brain abscesses, subdural empyemas, wound dehiscence, radiotherapic sequelae. Conclusions Our study shows that galea-pericranium alone (without sealants) is comparable to other duraplasty techniques that involve the use of sealants or of non-autologous pathches in terms of long term postoperative results. © 2014 Elsevier B.V.
AB - Objective Dural closure is one of the most critical steps in neurosurgical procedures as it prevents many common postoperative complications. Methods of dural closure include the use of allogenic, autogenic, xenogenic, absorbable or synthetic materials together with sealant/glues or hemostatic compounds. Most common autogenic graft is galea-pericranium. This study aims to demonstrate how the intrinsic properties of the galea-pericranium make effectively useless the application of any glue in order to ensure the watertight integrity of the graft. Patients and methods 276 cases were included in the study. Postoperative dural-closure related complication in patients subjected to duraplasty were analysed in three groups undergoing different duraplasty techniques: galea-pericranium graft without sealants, galea-pericranium graft plus sealant, non-autologous dural patch plus sealant. Results No statistically significant differences between the three groups were observed in terms of subcutaneous fluid collection rate, CSF fistulas, brain abscesses, subdural empyemas, wound dehiscence, radiotherapic sequelae. Conclusions Our study shows that galea-pericranium alone (without sealants) is comparable to other duraplasty techniques that involve the use of sealants or of non-autologous pathches in terms of long term postoperative results. © 2014 Elsevier B.V.
KW - Duraplasty
KW - Galea-pericranium
KW - Duraplasty
KW - Galea-pericranium
UR - http://hdl.handle.net/10807/149185
UR - http://www.elsevier.com/locate/clineuro
U2 - 10.1016/j.clineuro.2014.05.005
DO - 10.1016/j.clineuro.2014.05.005
M3 - Article
SN - 0303-8467
VL - 123
SP - 50
EP - 54
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
ER -