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Dural repair using acellular human dermis: experience with 200 cases: technique assessment
W L Warren1, M B Medary, C D Dureza
1Department of Neurosurgery, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. drleewarren@yahoo.com
Neurosurgery
|June 2, 2000
Summary
Acellular human dermal grafts (AlloDerm) provide a suitable alternative for watertight dural closure in craniotomies when autografts are unavailable. This dural substitute demonstrated good handling and no adhesion formation in 200 cases.
Area of Science:
- Neurosurgery
- Biomaterials
Background:
- Watertight dural closure is essential in many craniotomies.
- Autograft availability can be limited, necessitating alternative dural substitutes.
- Acellular human dermal grafts offer a potential solution for dural repair.
Observation:
- This study evaluated 200 craniotomies using acellular human dermal grafts (AlloDerm) as a dural substitute.
- Patients received the graft when autograft harvest was impractical or impossible.
- A running suture technique was employed to ensure a watertight seal.
Findings:
- After a minimum 1-year follow-up, 7 patients required further surgery.
- Three patients had cerebrospinal fluid leaks successfully repaired without graft removal.
- Four patients experienced wound infections necessitating debridement; the graft remained uninvolved.
Implications:
- AlloDerm is a viable alternative dural graft material.
- Its handling characteristics are comparable to native dura.
- The material is biologically inert and does not cause adhesion formation.