Collagen matrix in decompressive hemicraniectomy

Neurosurgery
Jorn A HoraczekAlexander Graewe

Abstract

Decompressive hemicraniectomy is an accepted treatment for otherwise untreatable intracranial hypertension. The aim of this prospective randomized study is to evaluate the benefit of application of collagen matrix as an onlay graft to reduce operating time during hemicraniectomy and to facilitate dural dissection during second-stage cranioplasty. Thirty-four consecutive patients were randomized to receive collagen matrix during hemicraniectomy or to undergo the conventional procedure. Specific time points were recorded during hemicraniectomy and cranioplasty. Intra- and postoperative complications, time course of Glasgow Coma Scale, Barthel's, and Early Rehabilitation Indices were monitored. The surgeon had to rate the convenience of the procedure if collagen matrix was used. Cost implications are discussed. The use of collagen matrix during hemicraniectomy resulted in a reduction of combined operating time for hemicraniectomy and cranioplasty by an average of 19.7%. The rate of cerebrospinal fluid effusion during cranioplasty was 13% when collagen was used and 58% in the control group. None of the patients who received collagen developed cerebrospinal fluid effusion persisting longer than 1 week, compared with 33% of patients ...Continue Reading

Citations

Feb 12, 2017·Neurosurgical Review·R B MoringlaneK L V Eckardstein
Sep 26, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Martin VychopenErdem Güresir

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