title: 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.
abstract: 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 Médical 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pharmacy, Sainte-Anne Hospital, Paris, France.
authors.forename: Miriam
authors.initials: M
authors.lastname: Malliti
authors.forename: Philippe
authors.initials: P
authors.lastname: Page
authors.forename: Charles
authors.initials: C
authors.lastname: Gury
authors.forename: Eric
authors.initials: E
authors.lastname: Chomette
authors.forename: François
authors.initials: F
authors.lastname: Nataf
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Roux
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D016025:Bone Transplantation; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy; D003428:Cross Infection / Q000209:etiology*; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D011091:Polyesters; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D014520:Urethane
chemical_list: D011091:Polyesters; D014520:Urethane