Time-sparing and effective procedure for dural closure in the posterior fossa using a vicryl mesh (Ethisorb)
| Autor: | I. Reyes-Moreno, R. Verheggen |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Reoperation
medicine.medical_specialty Percutaneous Polyesters Posterior fossa Vicryl mesh Suction Lumbar Cerebrospinal fluid Postoperative Complications Absorbable Implants otorhinolaryngologic diseases Postoperative infection Medicine Humans Fibrin glue Cerebellar Neoplasms Aged 80 and over Brain Diseases business.industry Surgical Mesh Subdural Effusion Surgery Cranial Fossa Posterior Dural closure Female Neurology (clinical) Dura Mater Neoplasm Recurrence Local business Polyglycolic Acid |
| Zdroj: | Neurocirugia (Asturias, Spain). 17(6) |
| ISSN: | 1130-1473 |
| Popis: | Summary Introduction . Dural defects and cerebrospinal fluid (CSF) leaks are a common problem following posterior fossa surgery. The management includes either nonoperative management (e.g. external lumbar drainage) or surgical re-exploration. Objectives We present our surgical, clinical and histopathological experience of dural closure in the posterior fossa. In order to avoid CSF leaks we developed a simple but effective and time-sparing method using a well-cut sheet of a vicryl-poly-pdioxanone mesh (Ethisorb ®) covering the whole defect of the craniectomy. Additional fibrin glue or sealant is not necessary. Special attention was focused upon the frequency of postoperative complications, in particular infection rate and CSF leaks. Patients 85 patients were treated with vicryl mesh as dural substitute after posterior fossa surgery due to distinct pathologies. An illustrative case is presented. Results In none of the patients a postoperative infection was observed. Four patients presented postoperative CSF leakage and were treated by percutaneous lumbar drainage. Three of the patients improved completely, requiring no additional treatment. Only in one case defect covered by a vicryl mesh, a surgical reexploration became necessary. Conclusion We consider the vicryl mesh (Ethisorb ®) as an ideal dural substitute especially for the dural closure of the posterior fossa. |
| Databáze: | OpenAIRE |
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