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Comparison of deep wound infection rates using a synthetic
dural substitute (neuro-patch) or pericranium graft for dural closure: a
clinical review of 1 year
Malliti M, Page P, Gury C, Chomette E, Nataf F, Roux FX
Department of Pharmacy, Sainte-Anne Hospital, Paris, France.
Objective. The need to repair dural defects has prompted the use of dura mater
substitutes.
Many synthetic materials have been used for dural closure.
Neuro-Patch (B. Braun Medical S.A., Boulogne, France) is a nonabsorbable
microporous fleece composed of polyester urethane that has been approved for
human use by the European Union since 1995.
To the best of our knowledge, no
clinical series with Neuro-Patch have been published thus far, particularly with
regard to septic complications.
The aim of our study was to compare the safety
of Neuro-Patch with that of pericranium graft with regard to postoperative wound
infections.
Methods. This is a retrospective study of 1 year's experience
including all patients who underwent dural plasty with a Neuro-Patch (n = 61) or
pericranium graft (n = 63).
The follow-up period was at least 12 months after
surgery.
Before wound infection rates in the two groups were compared, factors
suspected of being risks for neurosurgical site infection were evaluated.
Results. Patient characteristics (mean age, neurological diagnosis), surgical
procedures, prophylactic antibiotics, and risk factors for surgical infections
(including duration of surgery, emergency, contaminated operations, and external
cerebrospinal fluid drainage) were similar in the Neuro-Patch and pericranium
groups.
Deep wound infection rates in the Neuro-Patch and pericranium groups
were 15 and 5%, respectively (P = 0.06), and cerebrospinal fluid leaks were
significantly more frequent in the Neuro-Patch group (13 versus 1.6%, P <
0.05).
Conclusion. The results of our investigations show that Neuro-Patch
raised the risk of wound infection, as do foreign materials implanted in the
body.
Synthetic dural grafts should be reserved for when autologous grafts are
not sufficient or possible.
An extensive prospective multicenter randomized
trial is needed to confirm our results.
PMID: 15028133 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15028133
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