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Bovine pericardium for dural grafts:
clinical results in 35 patients.
Anson JA, Marchand EP
Division of Neurosurgery, University of New Mexico School
of Medicine, Albuquerque, USA.
OBJECTIVE: The United States Food and Drug Administration
has recently approved the marketing of bovine pericardium as a dural graft
material but literature reports of this use are limited. Bovine pericardium has
been widely used for grafts in cardiac surgery and seems to have suitable
properties for use as a dural graft. We report the use of glutaraldehyde
processed bovine pericardium for dural grafts in 35 patients undergoing cranial
and craniospinal operations with the objective of providing a clinical
assessment of this material and technique.
METHODS: This report is a retrospective analysis of 35
patients. All available records were reviewed and information regarding the
indication for grafting, graft size, complications and outcome were collected
and analyzed for all patients.
RESULTS: Indications for grafting included meningioma
resection, posterior fossa craniotomy, Chiari decompression, dural based
metastases, and trauma. Outcomes were good or excellent in 32 patients: the
three fair or poor outcomes were not related to surgical closure. In no patient
was the dural graft a significant factor in outcome. Bovine pericardium was
found to be easily sutured to be watertight using standard suture material. The
material is relatively inexpensive and requires no additional incision. It has
low antigenicity and toxicity, good strength, and minimal elasticity.
CONCLUSION: In this clinical assessment, bovine
pericardium was found to be an excellent dural graft material.
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