Suturing-Free Artificial Dura with Dacron Heart Patch in Decompressive Craniectomy and Cranioplasty

Abstract

Dacron heart patch has been used in decompressive craniectomy, performing the function of septa, mainly to prevent extra adhesion of temporal muscle and decompressive meningeal adhesion in the second-stage cranioplasty, so as to make the operation easier. Then, we made the following modification technology: (1) We used artificial suturing-free dura participate directly in the duraplasty. (2) Dacron patch is not in need of trimming the side holes and can directly cover the decompression window. From March 2012 to October 2013, we applied the technology of artificial dura with Dacron heart patch in 23 patients; after operation, we found that the initial depressive craniectomy cost less time, due to the tension-reduced suture which was not needed, and in the second-stage cranioplasty, the temporal was easy to remove and had no adhesion with the Dacron patch, so as to reach temporal muscle anatomy preservation, and with no obvious postoperative complication.

Large retrospective study of artificial dura substitute in patients with traumatic brain injury undergo decompressive craniectomy

“…Allograft of dura is very limited due to the availability of the donor. Biosynthesized materials have been widely used in dura repair, including collagen film (Wang et al., ), silk fibroin (Kim et al., ), polyethylene glycol hydrogel (Jito, Nitta, & Nozaki, ; Osbun et al., ; Than, Baird, & Olivi, ), and ePTFE (Matsumoto et al., ; Wang et al., ; Yamagata, Goto, Oda, & Kikuchi, ), not only in TBI, also in other neurosurgeries, such as tumor dissection. However certain complications were associated with these biosynthesized materials.…”

“…Many patients may have significant dura mater defect due to TBI itself or by surgery. The defective dura area may be left open without repair or sealed with artificial dura substitutes (Huang, Lee, Chen, & Wang, ; Mundinger et al., ; Wang et al., ; Zhang, Yang, Jiang, & Zeng, ). Both procedures have been widely used and have distinctive advantages and disadvantages, for instance, patients without dura repair may have increased risk of CSF leakage and infection, while have better decompressive effect.…”