Journal of Kerman University of Medical Sciences

Evaluation of the Results of Using Silicone Membrane between Muscle and Dura after Craniotomy in Patients Requiring Delayed Bone Replacement at the Craniotomy Site: A Prospective Cohort Trial

Document Type : Short Communication

Authors

Saied Abrishamkar 1
Mehdi Shafiei 2
Mehdi Mahmoodkhani 1
Ghasem Yadegarfar 2
Kamran Kaghazchi 1
Donya Sheibani Tehrani 3

1 Department of Neurosurgery, Isfahan University of Medical School, Isfahan, Iran

2 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical School, Isfahan, Iran

3 Department of Information Technology, Shahid Beheshti University, Tehran, Iran

https://doi.org/10.22062/jkmu.2022.91957
Abstract
Background: The adhesion between the dura and the muscle is one of the serious problems of patients who need delayed cranial bone replacement due to decompressive craniotomy after brain swelling, but there is no ideal solution to reduce this complication. This study aimed to determine the effect of implanting a silicone membrane between the muscle and the dura after craniotomy surgery in patients requiring delayed bone replacement at the craniotomy site.
Methods: In this clinical prospective cohort trial study with no evidence, all patients undergoing late cranial bone grafting after craniotomy were selected, and a total of 24 people were included in this study. During the craniotomy, a silicone mesh measuring 5 × 5 cm was placed between the dura and the muscle. Adhesion between the dura and the muscle and side effects associated with this procedure were examined during cranial bone grafting.
Results: Out of 24 patients requiring delayed cranial bone grafting, three individuals died and six individuals did not refer for cranioplasty; therefore, the operation was performed on 15 patients. During the operation, no cases of muscle-dura adhesion were observed, and in all 15 patients, the dura was completely detached from the muscle. Also, none of the patients presented side effects such as muscle bleeding at the surgery site, infection, and allergy to the mesh.
Discussion: Implantation of silicone layer between the dura and the muscle during craniotomy in patients suffering from cerebral edema can prevent muscle-dura adhesion without causing serious complications for the patients.

Keywords

Keywords: Cerebral edema
Craniotomy
Cranioplasty
Adhesion
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Journal of Kerman University of Medical Sciences
Volume 29, Issue 3
May and June 2022
Pages 307-312

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