Epidural blood patch: A study on an experimental model
Aim Epidural blood patch has been used to treat spinal headache with varying success. An experimental model was designed to ascertain whether an epidural blood patch can be used to seal the needle puncture sites in dural repair. Materials and Methods Bovine dura was secured to the lower...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2013-09-01
|
| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.124233 |
| _version_ | 1811339711340347392 |
|---|---|
| author | S.K. Sengupta |
| author_facet | S.K. Sengupta |
| author_sort | S.K. Sengupta |
| collection | DOAJ |
| description | Aim
Epidural blood patch has been used to treat spinal headache with varying success. An experimental model was designed to ascertain whether an epidural blood patch can be used to seal the needle puncture sites in dural repair.
Materials and Methods
Bovine dura was secured to the lower end of an open-ended calibrated plastic cylinder. Multiple interrupted stitches were applied over a 02 cm length of the dura without any incision. The cylinder was filled with colored saline gradually with the dura placed in a dependent position. Height of the water column at which sutured dura leaked was recorded. A layer of fresh blood was laid over the dura and allowed to clot. The test was repeated and the hydrostatic pressure at which leak took place was noted again. The test was repeated three times. Similar studies were done with two specimens with 02-cm dural incisions repaired with interrupted stitches of 4-0 silk in one specimen and 4-0 prolene in another, and three specimens with 3-mm unsutured dural rent in one and dural punctures made with 23-G and 26-G spinal needles in the other two.
Results
All the dural preparations leaked, at a very low hydrostatic pressure (<30 mm of H2O). By covering the needle puncture sites with clotted blood, a watertight closure could be achieved, that can withstand a much higher hydrostatic pressure (mean of 180 mm of H2O).
Conclusion
The experimental findings indicate that an epidural blood patch does enhance the ability of a dural closure to prevent a leak; however, its utility in clinical setting is questionable. |
| first_indexed | 2024-04-13T18:30:35Z |
| format | Article |
| id | doaj.art-909e9a8b738b48a8a356a900b286eb59 |
| institution | Directory Open Access Journal |
| issn | 2277-954X 2277-9167 |
| language | English |
| last_indexed | 2024-04-13T18:30:35Z |
| publishDate | 2013-09-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj.art-909e9a8b738b48a8a356a900b286eb592022-12-22T02:35:05ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-954X2277-91672013-09-01020326727010.4103/2277-9167.124233Epidural blood patch: A study on an experimental modelS.K. SenguptaAim Epidural blood patch has been used to treat spinal headache with varying success. An experimental model was designed to ascertain whether an epidural blood patch can be used to seal the needle puncture sites in dural repair. Materials and Methods Bovine dura was secured to the lower end of an open-ended calibrated plastic cylinder. Multiple interrupted stitches were applied over a 02 cm length of the dura without any incision. The cylinder was filled with colored saline gradually with the dura placed in a dependent position. Height of the water column at which sutured dura leaked was recorded. A layer of fresh blood was laid over the dura and allowed to clot. The test was repeated and the hydrostatic pressure at which leak took place was noted again. The test was repeated three times. Similar studies were done with two specimens with 02-cm dural incisions repaired with interrupted stitches of 4-0 silk in one specimen and 4-0 prolene in another, and three specimens with 3-mm unsutured dural rent in one and dural punctures made with 23-G and 26-G spinal needles in the other two. Results All the dural preparations leaked, at a very low hydrostatic pressure (<30 mm of H2O). By covering the needle puncture sites with clotted blood, a watertight closure could be achieved, that can withstand a much higher hydrostatic pressure (mean of 180 mm of H2O). Conclusion The experimental findings indicate that an epidural blood patch does enhance the ability of a dural closure to prevent a leak; however, its utility in clinical setting is questionable.http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.124233epidural blood patchexperimental modelwater-tight dural closure |
| spellingShingle | S.K. Sengupta Epidural blood patch: A study on an experimental model Indian Journal of Neurosurgery epidural blood patch experimental model water-tight dural closure |
| title | Epidural blood patch: A study on an experimental model |
| title_full | Epidural blood patch: A study on an experimental model |
| title_fullStr | Epidural blood patch: A study on an experimental model |
| title_full_unstemmed | Epidural blood patch: A study on an experimental model |
| title_short | Epidural blood patch: A study on an experimental model |
| title_sort | epidural blood patch a study on an experimental model |
| topic | epidural blood patch experimental model water-tight dural closure |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/2277-9167.124233 |
| work_keys_str_mv | AT sksengupta epiduralbloodpatchastudyonanexperimentalmodel |