Article
Use of oxidised regenerated cellulose instead of dura patch in patients undergoing decompressive craniectomies may increase risk of inflammatory complications – 5-year retrospective analysis
Anwendung von Hämostyptikum als Duraersatz bei Patienten mit dekompressiver Kraniektomie erhöht Risiko entzündlicher Komplikationen
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Authors
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Kazimierz Sadowy
- Kliniken der Stadt Köln gGmbH, Klinik für Neurochiurgie, Köln, Deutschland
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Rolf Lefering
- IFOM Universität Witten/Herdecke, Witten/Herdecke, Deutschland
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Makoto Nakamura
- Kliniken der Stadt Köln gGmbH, Klinik für Neurochirurgie, Köln, Deutschland
| Published: | May 8, 2019 |
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Outline
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Objective: To compare postoperative complication rates in patients undergoing decompressive craniectomies with and without use of oxidized regenerated cellulose as a dural substitute.
Methods: We performed a retrospective analysis of the patients undergoing decompressive craniectomies from January 2013 to December 2017. This study included 208 patients. The primary outcome of interest was occurrence of a postoperative complication of following groups: hemorrhagic complications, disturbance of CSF circulation, inflammatory complications and sinking skin flap syndrome. The second outcome of interest was the need of surgical intervention due to complications. A multivariate logistic regression was performed to explore associations between many variables including the kind of duraplasty (Audiomesh Neuro® vs. Tabotamp®), postoperative complications and necessity of surgical intervention for complications.
Results: Of the 208 Patients 168 (80,8%) developed at least one postoperative complication. Of those 168 Patients 58 (27,8%) needed a surgical intervention for complications.
There were no significant differences between the complication rates in patients with and without a dura patch with regard to hemorrhagic complication, disturbances of CSF circulations, sinking skin flap syndrome as well as necessity of surgical intervention for postoperative complications. Inflammatory complication were more likely in patients with Tabotamp® (11.1% vs. 3.1%; p=0.014). In multivariate analysis use of Tabotamp® in decompressive craniectomies was significantly associated with inflammatory complications (OR 5.07; 95% CI 1.02–24.92; p=0.046).
Conclusion: Patients undergoing decompressive craniectomies are at significantly higher risk of inflammatory complications if absorbable oxidized regenerated cellulose has been used instead of a dura patch.
