Experimental study on prevention of cerebrospinal fluid leakage by different dural suture methods in animals

English Keywords:Dural repair  Cerebral spinal fluid leak  Complication: Fibrin glue  Suture  Experiments on animals

English Abstract:

  【Abstract】 Objectives: To explore the effect of different dural suture techniques in preventing cerebrospinal fluid leakage(CSFL) through animal experiments. Methods: The spine of pig was used as an experimental object. The intact spinal cord and dura were harvested. One end of the dura cavity was closed and the other end was connected to the infusion device which could adjust the pressure by different heights(30, 50, 70, 90cmH2O). A 1.5cm durotomy was made by using a scalpel blade, then PDS(group A), Vicryl(group B) and Prolene(group C)(4-0, 5-0, 6-0, expectively) were selected to close the incision. Then, the drip tube of infusion set was opened. The flow rate of the fluid was measured by counting drops per minute from the drip chamber of the reservoir. The difference of the leakage flow rate by using different types of suture and different suture methods, including continuous locked versus, interrupted suture and running suture, and the effectiveness of fibrin glue. Results: In animal studies, there was no statistical difference between using PDS 4-0, 5-0, 6-0 and Prolene 4-0, 5-0, 6-0 suture. 5-0 vicryl was found to have significantly decreased leakage flow rate than 5-0 Prolene and 5-0 PDS II. There was no significant difference in the flow rate between the interrupted, running and continuous locked sutures(F=1.586, P＞0.05). In most cases, leakage occurred from the needle holes around sutures. The use of sealants could significantly reduce the leakage rate(F=39.66, P＜0.05). Conclusions: The using of Vicryl suture to repair the dura can significantly reduce the leakage flow rate, there is no significant difference in the flow rate between the interrupted, running and continuous locked sutures. The using of fibrin glue can improve the sealing effect of dural.