title: Galea-pericranium dural closure: can we safely avoid sealants?
abstract: OBJECTIVE
  Dural closure is one of the most critical steps in neurosurgical procedures as it prevents many common postoperative complications. Methods of dural closure include the use of allogenic, autogenic, xenogenic, absorbable or synthetic materials together with sealant/glues or hemostatic compounds. Most common autogenic graft is galea-pericranium. This study aims to demonstrate how the intrinsic properties of the galea-pericranium make effectively useless the application of any glue in order to ensure the watertight integrity of the graft.
  
  
  METHODS
  276 cases were included in the study. Postoperative dural-closure related complication in patients subjected to duraplasty were analysed in three groups undergoing different duraplasty techniques: galea-pericranium graft without sealants, galea-pericranium graft plus sealant, non-autologous dural patch plus sealant.
  
  
  RESULTS
  No statistically significant differences between the three groups were observed in terms of subcutaneous fluid collection rate, CSF fistulas, brain abscesses, subdural empyemas, wound dehiscence, radiotherapic sequelae.
  
  
  CONCLUSIONS
  Our study shows that galea-pericranium alone (without sealants) is comparable to other duraplasty techniques that involve the use of sealants or of non-autologous pathches in terms of long term postoperative results.
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Sabatino
authors.initials: S
authors.lastname: Giovanni
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy. Electronic address: gdellapepa@hotmail.com.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Della Pepa
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Rocca
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lofrese
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Alesso
authors.initials: A
authors.lastname: Albanese
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Maria
authors.affiliation: Institute of Neurosurgery, Catholic University of Rome, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Marchese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000379:methods; D004388:Dura Mater / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000517:prevention & control*; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014014:Tissue Adhesives
keywords: Duraplasty; Fibrin glue; Galea-pericranium; Sealants