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Assessment of cryoprecipitate-thrombin solution for dural repair
D A Wiegand1, M I Hartel, T Quander
1Department of Surgery, Milton S. Hershey College of Medicine, Hershey, Pennsylvania.
Head & Neck
|November 1, 1994
Summary
Fibrin-thrombin sealants provide a temporary biologic seal for dural closures. Cooling sealant components before mixing significantly enhances the strength of these tissue glues for dural defect repair.
Area of Science:
- Neurosurgery
- Biomaterials
- Surgical Sealants
Background:
- Fibrin-thrombin solutions serve as temporary biologic seals for dural closures after cranial and skull base tumor resection.
- These sealants facilitate healing of dural defects until complete tissue regeneration occurs.
Purpose of the Study:
- To investigate variables influencing the mechanical strength of fibrin-thrombin "tissue glues" for dural defect repair.
- To model clinical dural closure repairs using in vitro methods.
Main Methods:
- Assessed the competence of human cryoprecipitate-thrombin (CPT) "tissue glues" for watertight sealing of rat fascia and human cadaveric dural defects.
- Utilized a saline column to apply controlled pressure (up to 700 mm) over repaired defects.
- Investigated the impact of post-repair time, defect size, and mixing temperature on repair strength.
Main Results:
- Observed significant variability in the sealing strength of different CPT preparations.
- Found no significant effect of post-repair time on the strength of the dural seal.
- Demonstrated that cooling CPT components before mixing significantly increased repair strength.
- Noted similar outcomes across various defect sizes.
Conclusions:
- The integrity of fibrin glue repairs for dural defects exhibits wide variability under in vitro conditions.
- Repair strength was not correlated with fibrinogen concentration differences in the solutions.
- Pre-mixing cooling of CPT components is a critical factor in enhancing the mechanical strength of repaired dural defects.