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Clinics and Practice
Volume 6
Issue 2
10.4081/cp.2016.824
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.
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Brief Report

Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery

by
Verena Heymanns
1,
Abidemi W. Oseni
1,
Ameer Alyeldien
1,
Homajoun Maslehaty
2,
Richard Parvin
1,
Martin Scholz
1 and
Athanasios K. Petridis
3,*
1
Department of Neurosurgery, Sana Kliniken, Duisburg
2
Department of Neurosurgery, University Hospital, Essen
3
Department of Neurosurgery, Heinrich Heine University, Duesseldorf
*
Author to whom correspondence should be addressed.
Clin. Pract. 2016, 6(2), 824; https://doi.org/10.4081/cp.2016.824
Submission received: 10 November 2015 / Revised: 20 April 2016 / Accepted: 26 April 2016 / Published: 4 July 2016

Abstract

Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (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 significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil® (Takeda Pharma A/S, Roskilde, Denmark), Gelfoam® (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 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 treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.
Keywords: posterior fossa; dural closure; cerebrospinal fluid leak posterior fossa; dural closure; cerebrospinal fluid leak

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MDPI and ACS Style

Heymanns, V.; Oseni, A.W.; Alyeldien, A.; Maslehaty, H.; Parvin, R.; Scholz, M.; Petridis, A.K. Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery. Clin. Pract. 2016, 6, 824. https://doi.org/10.4081/cp.2016.824

AMA Style

Heymanns V, Oseni AW, Alyeldien A, Maslehaty H, Parvin R, Scholz M, Petridis AK. Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery. Clinics and Practice. 2016; 6(2):824. https://doi.org/10.4081/cp.2016.824

Chicago/Turabian Style

Heymanns, Verena, Abidemi W. Oseni, Ameer Alyeldien, Homajoun Maslehaty, Richard Parvin, Martin Scholz, and Athanasios K. Petridis. 2016. "Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery" Clinics and Practice 6, no. 2: 824. https://doi.org/10.4081/cp.2016.824

APA Style

Heymanns, V., Oseni, A. W., Alyeldien, A., Maslehaty, H., Parvin, R., Scholz, M., & Petridis, A. K. (2016). Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery. Clinics and Practice, 6(2), 824. https://doi.org/10.4081/cp.2016.824

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