Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery
Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of t...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2016-07-01
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| Series: | Clinics and Practice |
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| Online Access: | https://www.clinicsandpractice.org/index.php/cp/article/view/824 |
| _version_ | 1811212605830725632 |
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| author | Verena Heymanns Abidemi W. Oseni Ameer Alyeldien Homajoun Maslehaty Richard Parvin Martin Scholz Athanasios K. Petridis |
| author_facet | Verena Heymanns Abidemi W. Oseni Ameer Alyeldien Homajoun Maslehaty Richard Parvin Martin Scholz Athanasios K. Petridis |
| author_sort | Verena Heymanns |
| collection | DOAJ |
| description | Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature. |
| first_indexed | 2024-04-12T05:31:54Z |
| format | Article |
| id | doaj.art-073924f802ba43f3aa41774e6b67a733 |
| institution | Directory Open Access Journal |
| issn | 2039-7275 2039-7283 |
| language | English |
| last_indexed | 2024-04-12T05:31:54Z |
| publishDate | 2016-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Clinics and Practice |
| spelling | doaj.art-073924f802ba43f3aa41774e6b67a7332022-12-22T03:46:00ZengMDPI AGClinics and Practice2039-72752039-72832016-07-016210.4081/cp.2016.824346Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgeryVerena Heymanns0Abidemi W. Oseni1Ameer Alyeldien2Homajoun Maslehaty3Richard Parvin4Martin Scholz5Athanasios K. Petridis6Department of Neurosurgery, Sana Kliniken, DuisburgDepartment of Neurosurgery, Sana Kliniken, DuisburgDepartment of Neurosurgery, Sana Kliniken, DuisburgDepartment of Neurosurgery, University Hospital, EssenDepartment of Neurosurgery, Sana Kliniken, DuisburgDepartment of Neurosurgery, Sana Kliniken, DuisburgDepartment of Neurosurgery, Heinrich Heine University, DuesseldorfPosterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.https://www.clinicsandpractice.org/index.php/cp/article/view/824Posterior fossadural closurecerebrospinal fluid leak. |
| spellingShingle | Verena Heymanns Abidemi W. Oseni Ameer Alyeldien Homajoun Maslehaty Richard Parvin Martin Scholz Athanasios K. Petridis Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery Clinics and Practice Posterior fossa dural closure cerebrospinal fluid leak. |
| title | Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| title_full | Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| title_fullStr | Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| title_full_unstemmed | Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| title_short | Sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| title_sort | sandwich wound closure reduces the risk of cerebrospinal fluid leaks in posterior fossa surgery |
| topic | Posterior fossa dural closure cerebrospinal fluid leak. |
| url | https://www.clinicsandpractice.org/index.php/cp/article/view/824 |
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