Object: The goal of this study was to assess the necessity for the prophylactic use of dural tenting sutures.
Methods: Data that had been prospectively collected from 369 consecutive cranial operations in adults were analyzed. In this series of patients, dural tenting sutures were used on a judicious "as needed" basis. They were never used to satisfy a procedural routine or for use as a prophylaxis against epidural hemorrhage that was not apparent. Tenting sutures were used for the control of epidural bleeding in 33 patients (8.9%); no tenting was required in 336 patients (91.1%). Reoperation for postoperative epidural hematoma was not required in this series.
Conclusions: Dural tenting sutures continue to have an important role in neurosurgery; however, there is no compelling evidence to support their traditional prophylactic use in every intracranial operation.