title: Technique for decompressive craniectomy using Seprafilm as a dural substitute and anti-adhesion barrier.
abstract: Surgeons in abdominal and gynecological fields have pioneered the use of Seprafilm (a chemically modified sodium hyaluronate/carboxymethylcellulose absorbable adhesion barrier, Genzyme Biosurgery, Cambridge, MA, USA) to prevent adhesion but its use outside these specialties is not well documented. The authors have used Seprafilm for craniectomy closure in several patients as a dural substitute and anti-adhesion barrier. During emergent craniectomy, the dura mater is reapproximated and a layer of Seprafilm is placed over the dura as an onlay and anti-adhesion barrier. During subsequent surgery for bone flap replacement, dissection between the dural plane and overlying tissues has been completed easily. There has been minimal adhesion to the underlying Seprafilm/dural layer. The Seprafilm has been incorporated into the surrounding dural plane. No postoperative complications have been noted. Seprafilm's anti-adhesive properties and biodegradable characteristics make it useful as a dural onlay for craniectomy in which a second surgery is planned.
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT 84132, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Mumert
authors.forename: Tamer
authors.initials: T
authors.lastname: Altay
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications; D001929:Brain Edema / Q000209:etiology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications; D056424:Decompressive Craniectomy / Q000379:methods*; D004388:Dura Mater / Q000033:anatomy & histology; D006801:Humans; D006820:Hyaluronic Acid; D020244:Infarction, Middle Cerebral Artery / Q000150:complications; D008297:Male; D013524:Surgical Flaps; D000267:Tissue Adhesions / Q000517:prevention & control*; D055815:Young Adult
chemical_list: C118198:Seprafilm; D006820:Hyaluronic Acid