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[Technical procedure in the use of lyophilized dura for closure of extensive abdominal wall defects]
Insights
Lyophilized dura effectively repairs major thoracic and abdominal wall defects in pediatric surgery. Proper implantation and coverage ensure stable, incorporated repairs in children.
Area of Science:
- Pediatric Surgery
- Biomaterials Science
- Surgical Reconstruction
Context:
- Major defects in pediatric thoracic and abdominal walls require robust reconstructive solutions.
- The Steglitz Hospital of Berlin Free University has experience with various surgical interventions.
- Lyophilized dura mater is a potential biomaterial for tissue repair.
Purpose:
- To evaluate the efficacy and application of lyophilized dura mater in reconstructing major defects in pediatric patients.
- To assess the outcomes of lyophilized dura implantation in abdominal wall, diaphragm, and thoracic wall defects.
Summary:
- 122 pediatric patients with major defects underwent repair using lyophilized dura implantation.
- Procedures included 49 abdominal wall, 26 diaphragm, 14 thoracic wall, and 33 other site repairs.
- Successful incorporation and stabilization were achieved when dura was covered with endogenous tissues and securely anchored.
Impact:
- Lyophilized dura, when properly implanted and covered, provides a versatile and effective solution for extensive wall defects in children.
- Complete incorporation leads to a solid cicatricial plate, offering satisfactory stabilization.
- Safe anchoring techniques are crucial for successful outcomes in pediatric reconstructive surgery.
Abstract:
In the Department of Pediatric Surgery in the Steglitz Hospital of Berlin Free University, major defects in the thoracic and abdominal wall and other sites were treated in 122 children by implantation of lyophilised dura. Surgery was performed 49 times at the abdominal wall, 26 times at the diaphragm, 14 times at the thoracic wall, and 33 times in various other regions. Lyophilised dura, after it has been desantigenised and sterilised, is very versatile in application. However, it is necessary to avoid any area of contact with the lumen of the digestive tract, the tracheo-bronchial system and the body surface. If the implanted dura can be covered with endogenous soft parts and skin, complete incorporation is achieved with the formation of a solid cicatricial plate which provides satisfactory stabilisation of the wall even in extensive defects. Another essential prerequisite is safe anchoring of the dura implants, which can always be achieved if an appropriate suturing technique is employed.