Study of dural suture watertightness: an in vitro comparison of different sealants

被引:42
作者
Chauvet, Dorian [1 ,2 ]
Viet Tran [3 ]
Mutlu, Gurkan
George, Bernard [1 ,2 ]
Allain, Jean-Marc [3 ]
机构
[1] Grp Hosp Pitie Salpetriere, Dept Neurosurg, F-75014 Paris, France
[2] Lariboisiere Hosp, F-75014 Paris, France
[3] Ecole Polytech, Lab Solids Mech, Palaiseau, France
关键词
Cerebrospinal fluid leakage; Dural suture; In vitro study; Sealants; CEREBROSPINAL-FLUID LEAKS; HYDROGEL SEALANT; COLLAGEN FLEECE; FIBRIN GLUE; REPAIR; BIOGLUE(R); PREVENTION; ADHESIVE; CLOSURES; DUROTOMY;
D O I
10.1007/s00701-011-1197-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
CSF leakages constitute a major complication of intradural procedures, especially for posterior fossa and skull base surgery. Dural suture watertightness is a decisive issue, and neurosurgeons routinely use different products to reinforce their dural closure. We have designed an experimental system capable of testing CSF leak pressure levels in order to compare two types of sutures in vitro and particularly four different sealants. Twenty-five fresh human cadaveric dural samples were removed and prepared for testing in a pressure chamber system connected to a hydraulic pressure motor. CSF leak levels were objectively registered. First, simple interrupted stitches were compared to running simple closure on 50-mm linear suture. Secondly, four sealants (two sealants/glues, BioglueA (R), DurasealA (R); two haemostatics, TachosilA (R), TissucolA (R)) were tested. Statistical analysis was performed with paired Student's t-test. No significant difference between interrupted closure and running suture was observed (p = 0.079). All sealants increased the watertightness of the suture significatively. However, comparison of the means of the differences for each product revealed large variations. In the conditions of our experiment, one sealant (DurasealA (R)) and one haemostatic (TachosilA (R)) seemed to show better results. We observed two different types of leakage: at the dura-sealant interface and through the sealant itself. We have developed an experimental device capable of testing dural closure watertightness. Interrupted stitch suturing seemed no different from running simple closure. On the contrary, the sealants tested show different watertightness capacities.
引用
收藏
页码:2465 / 2472
页数:8
相关论文
共 28 条
[1]   EXPERIMENTAL CHARACTERIZATION OF THE LOCAL STRAIN FIELD IN A HETEROGENEOUS ELASTOPLASTIC MATERIAL [J].
ALLAIS, L ;
BORNERT, M ;
BRETHEAU, T ;
CALDEMAISON, D .
ACTA METALLURGICA ET MATERIALIA, 1994, 42 (11) :3865-3880
[2]   Hydrogel-induced cervicomedullary compression after posterior fossa decompression for Chiari malformation - Case report [J].
Blackburn, Spiros L. ;
Smyth, Matthew D. .
JOURNAL OF NEUROSURGERY, 2007, 106 (04) :302-304
[3]   Use of a novel absorbable hydrogel for augmentation of dural repair: Results of a preliminary clinical study [J].
Boogaarts, JD ;
Grotenhuis, JA ;
Bartels, RHMA ;
Beems, T .
NEUROSURGERY, 2005, 57 (01) :146-151
[4]   Sellar repair with fibrin sealant and collagen fleece after endoscopic endonasal transsphenoidal surgery [J].
Cappabianca, P ;
Cavallo, LM ;
Valente, V ;
Romano, I ;
D'Enza, AI ;
Esposito, F ;
de Divitiis, E ;
Laws, ER .
SURGICAL NEUROLOGY, 2004, 62 (03) :227-233
[5]   Safety and efficacy of a novel polyethylene glycol hydrogel sealant for watertight dural repair [J].
Cosgrove, G. Rees ;
Delashaw, Johnny B. ;
Grotenhuis, J. Andre ;
Tew, John M. ;
van Loveren, Harry ;
Spetzler, Robert F. ;
Payner, Troy ;
Rosseau, Gail ;
Shaffrey, Mark E. ;
Hopkins, L. Nelson ;
Byrne, Ricrard ;
Norbash, Alex .
JOURNAL OF NEUROSURGERY, 2007, 106 (01) :52-58
[6]   The use of fibrin glue in skin grafts and tissue-engineered skin replacements: A review [J].
Currie, LJ ;
Sharpe, JR ;
Martin, R .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2001, 108 (06) :1713-1726
[7]   BioGlue® for prevention of postoperative cerebrospinal fluid leaks in transsphenoidal surgery:: a case series [J].
Dusick, Joshua R. ;
Mattozo, Carlos A. ;
Esposito, Felice ;
Kelly, Daniel F. .
SURGICAL NEUROLOGY, 2006, 66 (04) :371-376
[8]   Dural repair with four spinal sealants: focused review of the manufacturers' inserts and the current literature [J].
Epstein, Nancy E. .
SPINE JOURNAL, 2010, 10 (12) :1065-1068
[9]   Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery [J].
Esposito, Felice ;
Dusick, Joshua R. ;
Fatemi, Nasrin ;
Kelly, Daniel F. .
NEUROSURGERY, 2007, 60 (04) :295-303
[10]   Surgical site infection associated with the use of bovine serum albumine-glutaraldehyde surgical adhesive (BioGlueA®) in cranial surgery: a case-control study [J].
Gaberel, Thomas ;
Borgey, France ;
Thibon, Pascal ;
Lesteven, Claire ;
Lecoutour, Xavier ;
Emery, Evelyne .
ACTA NEUROCHIRURGICA, 2011, 153 (01) :156-163