title: Simple intraoperative technique for minor dural gap repair using fibrin glue and oxidized cellulose.
abstract: BACKGROUND
  Several methods have been proposed to achieve a watertight dural closure, including the use of fibrin sealant to reinforce sutures. We propose a fast technique using oxidized cellulose and fibrin glue to achieve firm and watertight closure of minor dural defects in supratentorial cranial surgery.
  
  
  METHODS
  Oxidized cellulose is cut to the shape of the dural defect and applied as an onlay graft. Fibrin sealant is then applied over the cellulose and the dural margins defect. The web conformation of oxidized cellulose avoids adhesion of fibrin glue to the underlying cortical surface of the brain. This technique has been applied in 45 of 467 supratentorial craniotomies during two consecutive years. The procedure was performed in few seconds. Postoperatively, three patients developed subgaleal fluid collection, which resolved conservatively in two cases. There were no other complications or reoperations.
  
  
  CONCLUSIONS
  We used a piece of oxidized cellulose, reinforced by fibrin glue, as a sutureless graft with more ease and less technical demand than other techniques. The reported technique is a fast and valid alternative to small dural defect closure methods.
authors.affiliation: Department of Neurosurgery, San Giovanni, Addolorata Hospital, Rome, Italy. robertogazzeri@gmail.com
authors.forename: Roberto
authors.initials: R
authors.lastname: Gazzeri
authors.forename: Marcelo
authors.initials: M
authors.lastname: Galarza
authors.forename: Alex
authors.initials: A
authors.lastname: Alfieri
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Neroni
authors.forename: Raffaelino
authors.initials: R
authors.lastname: Roperto
mesh_terms: D000328:Adult; D000368:Aged; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D003399:Craniotomy; D004388:Dura Mater / Q000473:pathology / Q000601:surgery*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002483:Cellulose, Oxidized; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives