Muscle-flap salvage of prosthetic dural repair

Chung, Connie; Forte, Antonio J.; Momeni, Reza; Masood, Quratulain Fatima; Narayan, Deepak

doi:10.1016/j.bjps.2008.09.023

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…The risk of removal and replacement exceeds that of salvage. This argument is also supported by the observation that prosthetic material in an infected wound may be salvaged without immediate removal [ 3 ]. Presently, we adopted a strategy for salvaging the infected prosthetic dura with a muscle free flap.…”

Section: Discussionmentioning

confidence: 91%

“…Generally, the removal of foreign material from an infected wound is recommended to achieve wound healing. After that, some authors have achieved good results from the removal of infected prosthetic dura and reconstruction of the dura defect and dead space with a vascularized musculocutaneous free flap [ 1 3 ]. This may be a good option in some situations.…”

Section: Discussionmentioning

confidence: 99%

“…If the defect is not properly reconstructed, it will bring about a leakage of cerebrospinal fluid (CSF) and the possibility of secondary contamination [ 1 ]. Prosthetic dural materials, such as non-autologous and bovine pericardial grafts, are widely utilized in neurosurgery because they cover the dura defect and provide a watertight seal that prevents CSF leakage [ 2 3 ]. However, persistent and troublesome wound infections can prelude the development of life threatening infective complications.…”

Section: Introductionmentioning

confidence: 99%

“…As a result, some authors suggest that removal of the artificial material may be feasible. However, removing the dural patch and its replacement in infected and inflamed tissue may cause difficulty [ 3 4 ]. A muscle free flap is reported to be effective in the case of protracted and infected wounds because a good blood supply within the muscle can clear infections and ensure rapid wound recovery [ 5 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

Han

Park

et al. 2013

Arch Plast Surg

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BackgroundThe prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura.MethodsBetween 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed.ResultsAll 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months.ConclusionsThe combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

Han

Park

et al. 2013

Arch Plast Surg

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Proposing Novel Biological Scaffolds for the Regeneration of the Dura Mater

Monazah,

Alimohammadi,

Rostaminasab

et al. 2024

Polymers for Advanced Techs

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The dura mater protects underlying tissues and cerebrospinal fluid, but dural abnormalities can cause leaking and meningitis and wound infections. This review emphasizes the relevance of dural repair and the progress of dural reconstruction materials, focusing on biological scaffolds. A comprehensive assessment of dural substitution literature focused on composite, acellular, natural, synthetic, and homologous materials. Decellularized dura scaffolds as viable natural biomaterials for tissue engineering are explored in this overview of these materials' properties, effectiveness, and therapeutic uses. The evaluation also compares materials and assesses host tissue response in preclinical and clinical studies. The review highlights various dural substitution findings. There is no gold standard for dural repair, despite the variety of materials used. Replicating natural dura mater's mechanical and structural qualities is difficult. Recent research suggests that decellularized dura scaffolds can regenerate tissue while reducing inflammation and transplant rejection. Furthermore, the movement toward personalized medicine in this sector suggests that bespoke alternatives might be chosen depending on patient characteristics, improving treatment effects. Synthesizing dural replacement research and clinical uses in this review adds to knowledge. It tackles standard materials' shortcomings and shows how biological scaffolds might improve dural repair. The analysis opens the door to personalized dural repair research that might enhance patient outcomes and advance neurosurgery. The insights presented herein highlight the intriguing prospects for appropriate dural restorative materials, seeking to improve dural defect treatment.

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