Abstract：
OBJECTIVE:The optimal management of dural closure is unclear; therefore, we aimed to survey current common practices among Italian practitioners. METHODS:The Delphi method was used to achieve a consensus on dura mater closing techniques in Italy. A steering committee decided 3 major topics to be investigated: pre- and postoperative conditions associated with cerebrospinal fluid (CSF) leak, indications to perform watertight dural closure, and dural closure technique. A questionnaire containing 12 statements was then submitted to Italian neurosurgeons. RESULTS:The response rate was 60%. Among 60 items, 36 reached a positive consensus, 5 reached a negative consensus, and 19 did not reach consensus. Intrathecal hypertension, arachnoid opening, previous treatments, spinal incidental durotomy, wide size of osteo-dural defect, and lack of nasoseptal flap were considered major risk factors for CSF leak. Early mobilization, avoidance of stress maneuvers, and use of CSF external drainage were considered to reduce CSF leak rate. Italian neurosurgeons always attempt watertight dural closure, ideally with monofilament nonabsorbable sutures. Both autologous and heterologous dural grafts are used. Among dural sealants, fibrin glues are preferred, which are used most commonly in transsphenoidal surgery. CONCLUSIONS:This study elucidates the areas of consensus and uncertainty on dural closure management among a group of Italian neurosurgeons. It provides reliable and comparable data for the investigation of the departments' daily practice in dural closure. Given the lack of solid evidence, there is a need for further comparative studies of dural repair strategies.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
d'Avella E,Fazzolari B,Schiariti M,Delitala A,Ferroli P,Cappabianca P,Servadei Fdoi
10.1016/j.wneu.2019.05.125subject
Has Abstractpub_date
2019-09-01 00:00:00pages
e255-e263eissn
1878-8750issn
1878-8769pii
S1878-8750(19)31402-0journal_volume
129pub_type
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.08.150
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is associated with increased intracranial pressure, and these patients are unstable with a high risk of rebleeding. Computed tomography angiography (CTA) has been proposed as an examination tool for the rapid detection of ruptured aneurysms. We aimed to de...
journal_title：World neurosurgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.wneu.2016.03.099
更新日期：2016-07-01 00:00:00
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journal_title：World neurosurgery
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journal_title：World neurosurgery
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doi：10.1016/j.wneu.2016.12.094
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pub_type： 杂志文章
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journal_title：World neurosurgery
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doi：10.1016/j.wneu.2019.05.197
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.11.145
更新日期：2017-02-01 00:00:00
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journal_title：World neurosurgery
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doi：10.1016/j.wneu.2012.03.032
更新日期：2013-01-01 00:00:00
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journal_title：World neurosurgery
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更新日期：2020-07-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2014.08.010
更新日期：2014-12-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.05.049
更新日期：2018-08-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2019-12-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,meta分析,评审
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更新日期：2015-10-01 00:00:00
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journal_title：World neurosurgery
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doi：10.1016/j.wneu.2019.12.032
更新日期：2020-03-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.04.029
更新日期：2018-07-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.wneu.2016.11.037
更新日期：2017-02-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.02.090
更新日期：2017-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2020.07.114
更新日期：2020-11-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2016.06.114
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2018-06-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2010.05.010
更新日期：2010-08-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2017-12-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.04.192
更新日期：2018-07-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2017.03.059
更新日期：2017-06-01 00:00:00
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journal_title：World neurosurgery
pub_type：
doi：10.1016/j.wneu.2020.06.121
更新日期：2020-09-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
doi：10.1016/j.wneu.2018.04.107
更新日期：2018-07-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章
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更新日期：2018-10-01 00:00:00
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journal_title：World neurosurgery
pub_type： 杂志文章,评审
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更新日期：2017-01-01 00:00:00
