Ceren Kizmazoglu1, Safak Ozyoruk2, Resit Bugra Husemoglu3, Orhan Kalemci1, Gulden Sozer4, Burak Sade1. 1. Department of Neurosurgery, Dokuz Eylul University School of Medicine, Izmir, Turkey. 2. Department of Neurosurgery, Ardahan State Hospital, Ardahan, Turkey. 3. Department of Biomechanics, Dokuz Eylul University School of Medicine Health Science Institute, Izmir, Turkey. 4. Department of Pathology, Forensic Medicine Institution, Izmir, Turkey.
Abstract
Introduction: Dural closure preference has been a topic of debate in contemporary neurosurgery. This study aims to compare different closure techniques using an in vitro model. Methods: Human cadaveric dura mater was attached to a cylindrical metal glass filled with blue dyed saline. A 1 cm dural incision was made. Dural closure was performed using three different techniques. Each group had six samples: Group I - interrupted simple 4-0 polyglactin suture (S) only, Group II - S plus on lay collagen graft, Group III - S plus fibrin sealant. In Group NS, a 1 cm × 1 cm dural window was made. An onlay collagen graft was used with no suturing for this group to serve as an overtly weak reconstruction reference. Primary and secondary leak pressures were recorded (PLP and SLP, respectively). Results: All groups (I-III) had significantly higher PLP and SLP than Group NS. PLP was significantly higher in Group III as compared to groups I and II. Groups I and II had similar PLP values. SLP was similar in all three groups. Conclusion: In this study, the use of fibrin sealant has proven to be the best option in preventing dural leak. However, no technique was superior in the case of SLP.
Introduction: Dural closure preference has been a topic of debate in contemporary neurosurgery. This study aims to compare different closure techniques using an in vitro model. Methods:Human cadaveric dura mater was attached to a cylindrical metal glass filled with blue dyed saline. A 1 cm dural incision was made. Dural closure was performed using three different techniques. Each group had six samples: Group I - interrupted simple 4-0 polyglactin suture (S) only, Group II - S plus on lay collagen graft, Group III - S plus fibrin sealant. In Group NS, a 1 cm × 1 cm dural window was made. An onlay collagen graft was used with no suturing for this group to serve as an overtly weak reconstruction reference. Primary and secondary leak pressures were recorded (PLP and SLP, respectively). Results: All groups (I-III) had significantly higher PLP and SLP than Group NS. PLP was significantly higher in Group III as compared to groups I and II. Groups I and II had similar PLP values. SLP was similar in all three groups. Conclusion: In this study, the use of fibrin sealant has proven to be the best option in preventing dural leak. However, no technique was superior in the case of SLP.
Authors: Ivanna Nebor; Ahmed E Hussein; Kora Montemagno; Rebecca Fumagalli; Ikrame Labiad; Alice Xu; Zoe Anderson; Yash Patil; Ahmad R Sedaghat; Jonathan A Forbes Journal: J Neurol Surg B Skull Base Date: 2021-03-02
Authors: Ivanna Nebor; Zoe Anderson; Juan C Mejia-Munne; Ahmed Hussein; Kora Montemagno; Rebecca Fumagalli; Ikrame Labiad; Yash Patil; Norberto Andaluz; Ahmad R Sedaghat; Mario Zuccarello; Jonathan A Forbes Journal: J Neurol Surg B Skull Base Date: 2021-11-08