Dural reconstruction with usage of xenogenic bio­material


Authors: Z. Večeřa 1;  O. Krejčí 1;  M. Houdek 1;  R. Lipina 1;  M. Kanta 2
Authors‘ workplace: Neurochirurgická klinika LF OU a FN Ostrava 1;  Neurochirurgická klinika LF UK a FN Hradec Králové 2
Published in: Cesk Slov Neurol N 2018; 81(6): 686-690
Category: Original Paper
doi: 10.14735/amcsnn2018686

Overview

Introduction:

Watertight dural reconstruction represents the golden standard of every intradural surgery.

Aim:

Autologous graft versus xenogenic graft comparison in dural reconstruction. Patients and methods: Our prospective study evaluated data of 86 patients who underwent a neurosurgical procedure. We divided patients into two groups. We used an autologous graft (fascia, periost) in the first group and xenogenic bio­material in the second group to perform dural reconstruction. Xenogenic biomaterial was Dural graft Biodesign® (Cook-Medical, Bloomington, IN, USA). In both groups, we assessed the incidence of cerebrospinal fluid leakage, infectious and non-infectious complications of wound healing.

Results:

Cerebrospinal fluid leakage occurred in the group with the xenogenic dural graft in 11.6% and in the group with the autologous graft in 9.3%. Infection rate was low, 4.6% in both groups. All patients received standard wound care according to the workplace routine. We detected no alergic reaction or graft rejection in any of our patients. Complete follow up was successful in 77 cases (89.5%) of all pacients. Difference between incidence of liquor fistula showed no statistical difference in both groups (p < 0.05).

Conclusion:

Application of xenogenic graft is very easy and simple and we consider it suitable for dural reconstruction.

Klíčová slova:

tvrdá plena – likvorová píštěl – meningitida – neurochirurgie

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Chinese summary - 摘要

使用异种生物材料进行硬脑膜重建

介绍:

水密硬脑膜重建是每次硬膜内手术的黄金标准。

目标:

硬脑膜重建中自体移植与异种移植的比较。

患者和方法:我们的前瞻性研究评估了86例接受神经外科手术的患者的数据。 我们将患者分为两组。 我们在第一组使用自体移植物(筋膜,骨膜),在第二组使用异种生物材料进行硬脑膜重建。 异种生物材料是Dural graft Biodesign(Cook-Medical,Bloomington,IN,USA)。 在两组中,我们评估了脑脊液漏,伤口愈合的感染性和非感染性并发症的发生率。

结果:

异种硬膜移植组发生脑脊液漏11.6%,自体移植组9.3%。 感染率低; 两组均为4.6%。 所有患者均根据工作场所常规接受标准伤口护理。 我们在任何患者中均未发现过敏反应或移植排斥反应。 所有患者中77例(89.5%)完成随访。 两组间酒瘘发生率差异无统计学差异(p <0.05)。

结论:

异种移植物的应用非常简单,我们认为它适用于硬脑膜重建。

关键词:

硬脑膜 - 脑脊液漏 - 脑膜炎 - 神经外科


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Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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2018 Issue 6

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