Tension-reduced suture of dura mater with artificial dura for cerebral protection following decompressive craniectomy of craniocerebral trauma

Abstract

Objective To investigate the brain protection of tension suture of dura-mater with artificial dura after decompressive craniectomy in craniocerebral trauma. Methods The study retrospectively analyzed craniocerebral trauma patients managed with standard decompressive craniectomy in the presence (study group, n=52) or absence of dura mater close (control group, n=46). Clinical data, such as postoperative CT images, days of stay in ICU, Glasgow Outcome Scale (GOS) 12 months after injury, morbidity of epilepsy, acroparalysis, Barthel index (BI) and mini-mental status examination (MMSE) were analyzed and compared between the two groups. Results Occurrence rates of combined encephalocele and cerebral infarction around skull windows according to post-operative CT scan were 4% (2/52) in study group and 22% (10/46) in control group (P 0.05), but days of stay in ICU [(8.7±4.3)d vs (12.2±7.2)d], acroparalysis (myodynamia<grade Ⅲ) [10% (4/42) vs 31% (11/36)], BI [(73.9±18.9) vs (51.6±21.8)] and MMSE [(23.5±7.0) vs (19.2±6.9)] were significantly different (P<0.05). Conclusion To close the dura-mater by tension-reduced suture with artificial dura suggests a good protective effect on brain function, for it improves the daily activity capabilities and cognitive function in craniocerebral trauma patients treated with decompressive craniectomy. Key words: Craniocerebral trauma; Dura mater; Decompression, surgical