J A Anson1, E P Marchand. 1. Division of Neurosurgery, University of New Mexico School of Medicine, Albuquerque, USA.
Abstract
OBJECTIVE: The United States Food and Drug Administration has recently approved the marketing of bovine pericardium as a dural graft material, but literature reports of this use are limited. Bovine pericardium has been widely used for grafts in cardiac surgery and seems to have suitable properties for use as a dural graft. We report the use of glutaraldehyde-processed bovine pericardium for dural grafts in 35 patients undergoing cranial and craniospinal operations with the objective of providing a clinical assessment of this material and technique. METHODS: This report is a retrospective analysis of 35 patients. All available records were reviewed and information regarding the indication for grafting, graft size, complications, and outcome were collected and analyzed for all patients. RESULTS: Indications for grafting included meningioma resection, posterior fossa craniotomy, Chiari decompression, dural-based metastases, and trauma. Outcomes were good or excellent in 32 patients; the three fair or poor outcomes were not related to surgical closure. In no patient was the dural graft a significant factor in outcome. Bovine pericardium was found to be easily sutured to be watertight using standard suture material. The material is relatively inexpensive and requires no additional incision. It has low antigenicity and toxicity, good strength, and minimal elasticity. CONCLUSION: In this clinical assessment, bovine pericardium was found to be an excellent dural graft material.
OBJECTIVE: The United States Food and Drug Administration has recently approved the marketing of bovine pericardium as a dural graft material, but literature reports of this use are limited. Bovine pericardium has been widely used for grafts in cardiac surgery and seems to have suitable properties for use as a dural graft. We report the use of glutaraldehyde-processed bovine pericardium for dural grafts in 35 patients undergoing cranial and craniospinal operations with the objective of providing a clinical assessment of this material and technique. METHODS: This report is a retrospective analysis of 35 patients. All available records were reviewed and information regarding the indication for grafting, graft size, complications, and outcome were collected and analyzed for all patients. RESULTS: Indications for grafting included meningioma resection, posterior fossa craniotomy, Chiari decompression, dural-based metastases, and trauma. Outcomes were good or excellent in 32 patients; the three fair or poor outcomes were not related to surgical closure. In no patient was the dural graft a significant factor in outcome. Bovine pericardium was found to be easily sutured to be watertight using standard suture material. The material is relatively inexpensive and requires no additional incision. It has low antigenicity and toxicity, good strength, and minimal elasticity. CONCLUSION: In this clinical assessment, bovine pericardium was found to be an excellent dural graft material.
Authors: Juan F Martínez-Lage; Miguel A Pérez-Espejo; Joaquín Hernández Palazón; Francisco López Hernández; Pablo Puerta Journal: Childs Nerv Syst Date: 2005-09-27 Impact factor: 1.475