Artikel
Sandwich wound closure reduces the risk of CSF leaks in posterior fossa surgery
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: The risk of 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 the number of CSF leaks significantly.
Method: Technical report and retrospective analysis: 310 patients were treated in our hospital in the years 2009-2013 for posterior fossa pathologies. The dura was closed in the following fashion: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, Tachosil, Gelfoam and PMMA (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure such as CSF leakage, infections, bleeding is evaluated.
Results: 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 which was treated with antibiotics.
Conclusions: We introduce a sandwich wound closure for posterior fossa surgery which leads to a significant reduction of CSF leaks compared to the data in the literature.