Evaluation of the safety and effectiveness of a sealant hemostatic patch for preventing cerebrospinal fluid leaks in cranial surgery

Expert Rev Med Devices. 2021 Nov;18(11):1111-1116. doi: 10.1080/17434440.2021.1988850. Epub 2021 Oct 20.

Abstract

Background: Cerebrospinal fluid (CSF) leak remains a significant source of morbidity after neurosurgical procedures. The objective is to evaluate the effectiveness and safety of a polyethylene glycol-coated collagen patch (PCC) in different neurosurgical procedures.

Methods: A retrospective, single-center cohort study in patients who underwent a cranial neurosurgical procedure. After collecting multiple data variables, patients were divided into two groups depending on the use of PCC as sealant on dural closure following procedures.

Results: Data from 230 patients were collected (PCC, 128; control group, 102). Incidence of CSF leakage was significantly lower in the PCC group (p < .001). Complications that were significantly lower in PCC than the control group included surgical infection (p = .022), and hydrocephalus (p = .017), as well as reduced rates of reintervention (p < .001) and shorter hospital stays (p = .028). Factors associated with a higher incidence of CSF leakage included posterior fossa procedures, reinterventions, and the need for CSF drainage placement. PCC reduced the risk of suffering CSF leakage by more than 75% (p = .002) once adjusted for age, surgical approach, type of cranial opening, reintervention, CSF drainage, dural substitute, and dural defect coverage.

Conclusions: Our findings confirm PCC as an effective means of preventing CSF leakage following cranial neurosurgery with fewer associated complications.

Keywords: Cerebrospinal fluid leakage; cranial surgery; dural repair; dural sealant; sealant hemostatic patch; watertight dural closure.

MeSH terms

  • Cerebrospinal Fluid Leak / prevention & control
  • Cohort Studies
  • Dura Mater / surgery
  • Hemostatics* / therapeutic use
  • Humans
  • Neurosurgical Procedures / adverse effects
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies

Substances

  • Hemostatics