Use of the bovine pericardial patch and fibrin sealant in meningomyelocele closure

Background Meningomyelocele is the most common and complex birth defect of the central nervous system. The operative principle of meningomyelocele repair consists of consecutive separate closures of the neural placode, dura mater, lumbar fascia, subcutaneous layer, and skin. While the neurosurgical...

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Bibliographic Details
Published in:Acta neurochirurgica 2014-07, Vol.156 (7), p.1345-1350
Main Authors: Gürer, Bora, Kertmen, Hayri, Akturk, Umut Dogu, Kalan, Mehmet, Sekerci, Zeki
Format: Article
Language:English
Subjects:
Animals
Cattle
Clinical Article - Pediatrics
Dura Mater - surgery
Female
Fibrin Tissue Adhesive
Humans
Infant
Interventional Radiology
Male
Medicine
Medicine & Public Health
Meningomyelocele - surgery
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Pericardium
Postoperative Complications - epidemiology
Reconstructive Surgical Procedures - methods
Surgical Orthopedics
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Summary:Background Meningomyelocele is the most common and complex birth defect of the central nervous system. The operative principle of meningomyelocele repair consists of consecutive separate closures of the neural placode, dura mater, lumbar fascia, subcutaneous layer, and skin. While the neurosurgical techniques for the closure of the neural placode and dura mater have been well accepted, the most appropriate soft tissue closure technique has not yet been applied. Methods This study reviews a case series of eight meningomyelocele patients treated with the bovine pericardial patch and fibrin sealant. Following the reconstruction of the neural placode and the closure of the dura mater, soft tissue coverage was achieved using the bovine pericardial patch and fibrin sealant. Results In this series of eight patients, stable coverage was achieved with the application of a bovine pericardial patch and fibrin sealant technique. After the operations, none of the possible complications such as cerebrospinal fluid leak, seroma, hematoma, skin necrosis, deep or superficial infection, and wound breakdown was observed. Conclusions The usage of the bovine pericardial patch and fibrin sealant technique at the fascial level–between the dural sac and the skin–provides adequate soft tissue coverage in meningomyelocele repair surgery.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-014-2099-4