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Acta Neurochirurgica

, Volume 153, Issue 12, pp 2465–2472 | Cite as

Study of dural suture watertightness: an in vitro comparison of different sealants

  • Dorian Chauvet
  • Viet Tran
  • Gurkan Mutlu
  • Bernard George
  • Jean-Marc Allain
Experimental research

Abstract

Background

CSF leakages constitute a major complication of intradural procedures, especially for posterior fossa and skull base surgery. Dural suture watertightness is a decisive issue, and neurosurgeons routinely use different products to reinforce their dural closure. We have designed an experimental system capable of testing CSF leak pressure levels in order to compare two types of sutures in vitro and particularly four different sealants.

Methods

Twenty-five fresh human cadaveric dural samples were removed and prepared for testing in a pressure chamber system connected to a hydraulic pressure motor. CSF leak levels were objectively registered. First, simple interrupted stitches were compared to running simple closure on 50-mm linear suture. Secondly, four sealants (two sealants/glues, Bioglue®, Duraseal®; two haemostatics, Tachosil®, Tissucol®) were tested. Statistical analysis was performed with paired Student’s t-test.

Results

No significant difference between interrupted closure and running suture was observed (p = 0.079). All sealants increased the watertightness of the suture significatively. However, comparison of the means of the differences for each product revealed large variations. In the conditions of our experiment, one sealant (Duraseal®) and one haemostatic (Tachosil®) seemed to show better results. We observed two different types of leakage: at the dura-sealant interface and through the sealant itself.

Conclusions

We have developed an experimental device capable of testing dural closure watertightness. Interrupted stitch suturing seemed no different from running simple closure. On the contrary, the sealants tested show different watertightness capacities.

Keywords

Cerebrospinal fluid leakage Dural suture In vitro study Sealants 

Notes

Acknowledgment

The authors thank Damien Bresson, MD, Emmanuel Mandonnet, MD, PhD, and Yanek Chiu, MD, PhD, for their assistance and reviewing.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Dorian Chauvet
    • 1
  • Viet Tran
    • 2
  • Gurkan Mutlu
    • 3
  • Bernard George
    • 1
  • Jean-Marc Allain
    • 2
  1. 1.Department of NeurosurgeryGroupe Hospitalier Pitié-Salpêtrière and Lariboisiere HospitalParisFrance
  2. 2.Laboratory of Solids Mechanics, Ecole PolytechniquePalaiseauFrance
  3. 3.Urgences Cérébro-Vasculaires, Groupe Hospitalier Pitié-SalpêtrièreParisFrance

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