Use of an Absorbable Synthetic Polymer Dural Substitute for Repair of Dural Defects: A Technical Note

Abstract

Repair of the dura after cranial neurosurgery can present a technical challenge and, for certain neurosurgical procedures, is critical to prevent cerebrospinal fluid leak and associated wound complications. Multiple options exist for dural repair, including the patient's own tissues, bovine collagen-derived commercially available grafts, as well as newer, entirely synthetic graft materials. This is the first report of surgical experience with a new synthetic and absorbable dura substitute which has recently gained Food and Drug Administration (FDA) approval. Four patients underwent dural reconstruction with a new graft material after cranial neurosurgery when the dura was unrepairable directly. The synthetic graft material demonstrated satisfactory surgical qualities, was effective in dural repair, and no complications were attributable to the graft. Dural repair after craniotomy is an often desirable surgical outcome in neurosurgery. Surgeons seeking new graft materials may find this new absorbable, entirely synthetic material favorable for dural repair.

Keywords: cerebrospinal fluid leak; dura mater; polydioxanone; polyglycolic acid; wound healing.

Figure 1. Dural defect repaired with synthetic dural substitute.

Case 4: A 59-year-old man underwent a frontotemporal craniotomy for left medial sphenoid wing meningioma. The dural defect was closed using Cerafix secured with running 4-0 Neurolon suture (Panels A and B, enlarged).