Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

A method to prevent cerebrospinal fluid leakage: Reinforcing acellular dermal matrix

  • Lee, Hojune (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Eom, Ye Seul (JJ Plastic Surgery Center) ;
  • Pyon, Jai-Kyong (Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2019.10.01
  • Accepted : 2020.01.23
  • Published : 2020.02.20
Download PDF
⟨ Previous Next ⟩

Abstract

In neurosurgical cases, problems related to wound healing can vary from simple wound dehiscence to multilayer defects. This study demonstrates an effective method to prevent persistent cerebrospinal fluid (CSF) leakage using reinforcing acellular dermal matrix in neurosurgical patients with wound dehiscence. A 52-year-old woman was admitted for management of recurrent glioblastoma. After tumor removal surgery, the patient experienced sustained CSF leakage from the wound despite reparative attempts. The plastic surgery team performed wound repair procedure after remnant tumor removal by the neurosurgery team. Acellular dermal matrix was applied over the mesh plate to prevent CSF leakage and the postoperative status of the patient was evaluated. No sign of CSF leakage was found in the immediate postoperative period. After 3 years, there were no complications including CSF leakage, wound dehiscence, and infection. We hereby propose this method as a feasible therapeutic alternative for preventing CSF leakage in patients experiencing wound problem after neurosurgical procedures.

Keywords

References

  1. Krishnan KG, Muller A, Hong B, Potapov AA, Schackert G, Seifert V, et al. Complex wound-healing problems in neurosurgical patients: risk factors, grading and treatment strategy. Acta Neurochir (Wien) 2012;154:541-54. https://doi.org/10.1007/s00701-011-1221-0
  2. Babuccu O, Kalayci M, Peksoy I, Kargi E, Cagavi F, Numanoglu G. Effect of cerebrospinal fluid leakage on wound healing in flap surgery: histological evaluation. Pediatr Neurosurg 2004;40:101-6. https://doi.org/10.1159/000079850
  3. Rotenberg BW, Marchie A, Cusimano MD. Skin sealants: an effective option for closing cerebrospinal fluid leakage. Can J Surg 2004;47:466-8.
  4. Brunetti B, Tenna S, Segreto F, Persichetti P. The use of acellular dermal matrix in reconstruction of complex scalp defects. Dermatol Surg 2011;37:527-9. https://doi.org/10.1111/j.1524-4725.2011.01913.x
  5. Prickett KK, Wise SK, Delgaudio JM. Choice of graft material and postoperative healing in endoscopic repair of cerebrospinal fluid leak. Arch Otolaryngol Head Neck Surg 2011;137:457-61. https://doi.org/10.1001/archoto.2011.12
  6. Ismail AS, Costantino PD, Sen C. Transnasal transsphenoidal endoscopic repair of CSF leakage using multilayer acellular dermis. Skull Base 2007;17:125-32. https://doi.org/10.1055/s-2007-970556
  7. Bowers CA, Brimley C, Cole C, Gluf W, Schmidt RH. Allo-Derm for duraplasty in Chiari malformation: superior outcomes. Acta Neurochir (Wien) 2015;157:507-11. https://doi.org/10.1007/s00701-014-2263-x
  8. Mericli AF, Gampper TJ. The use of an acellular dermal matrix "sandwich" for the successful treatment of a persistent cranial cerebrospinal fluid fistula. J Craniofac Surg 2013;24:1314-6. https://doi.org/10.1097/SCS.0b013e3182953a39
  9. Wong AK, Schonmeyr B, Singh P, Carlson DL, Li S, Mehrara BJ. Histologic analysis of angiogenesis and lymphangiogenesis in acellular human dermis. Plast Reconstr Surg 2008;121:1144-52. https://doi.org/10.1097/01.prs.0000302505.43942.07

Cited by

  1. No-fat diet for treatment of donor site chyle leakage in vascularized supraclavicular lymph node transfer vol.21, pp.6, 2020, https://doi.org/10.7181/acfs.2020.00437
  2. Urethral Tissue Reconstruction Using the Acellular Dermal Matrix Patch Modified with Collagen-Binding VEGF in Beagle Urethral Injury Models vol.2021, 2020, https://doi.org/10.1155/2021/5502740