title: Dural repair using autologous fat: Our experience and review of the literature.
abstract: BACKGROUND
  Various materials have been proposed to obliterate dead spaces and to reconstruct dural defects during a neurosurgical approach. This study describes our technique of using the abdominal autologous fat graft and evaluates the complications and characteristics related to the use of this tissue during cranial procedures.
  
  
  METHODS
  Autologous fat grafts were used in 296 patients with basicranial and convexity extraaxial tumors from April 2005 to January 2015. The adipose tissue was removed from the paraumbilical abdominal region and was transformed into a thin foil. When possible, a watertight suture was made between the dural or bone edge with a fat graft. We always used fibrin glue to reinforce the dural closure.
  
  
  RESULTS
  Complications occurred between 2 days and 1 year following procedure. Cerebrospinal fluid leaks were found in 11 cases. No case of mortality, pseudomeningoceles, fistula, infections, bacterial meningitides, or lipoid meningitides was reported. No patient required removal of the graft. No adhesion was observed between the brain and the autologous fat. Other fat-related complications observed were 2 cases of fat necrosis in the abdomen and 2 cases of abdominal hemorrhage.
  
  
  CONCLUSIONS
  The technique of harvesting and applying fat grafts is fairly simple, although it must be performed meticulously to be effective. Our experience has led us to believe that the use of fat grafts presents low morbidity and mortality. However, a neurosurgeon should never forget the possible late or early complications related to the use of fat grafts.
authors: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors: Hambra
authors: H
authors: Di Vitantonio
authors: Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy.
authors: Danilo
authors: D
authors: De Paulis
authors: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors: Mattia
authors: M
authors: Del Maestro
authors: Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy.
authors: Alessandro
authors: A
authors: Ricci
authors: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors: Soheila Raysi
authors: SR
authors: Dechordi
authors: Department of Neurosurgery, San Salvatore City Hospital, L'Aquila, Italy.
authors: Sara
authors: S
authors: Marzi
authors: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors: Daniele F
authors: DF
authors: Millimaggi
authors: Department of Life, Health and Environmental Sciences (MESVA), University of L'Aquila, L'Aquila, Italy.
authors: Renato J
authors: RJ
authors: Galzio
keywords: Autologous fat graft; dural repair; dural substitute; watertight suture