Vranković D, Hećimović I, Splavski B, Dmitrović B
Section of Neurosurgery, General Hospital Osijek, Croatia.
Neurochirurgia (Stuttg). 1992 Sep;35(5):150-5. doi: 10.1055/s-2008-1052268.
Over the period of seven months: from July 1991 to January 1992 sixty-nine patients with penetrating head war-injuries, were admitted in our hospital. Missile wounds of the dura mater require in most cases urgent operative management: watertight closure of the dura defects. However, a dilemma still exists as to the best material to be used to restore the missile dural defects. There are several possibilities: an autologous substitute as periosteum (pericranium) from surrounding, fascia of the temporalis muscle, fascia lata, or allograft transplant as lyophilised cerebral dura mater (lyodura). In the group of 69 patients, 7 were treated conservatively, 13 were treated surgically, but without closing the dural wounds because of their critical condition, and in 45 surgically treated patients the dural defects were covered with 53 transplants: with periosteum in 22 patients but 24 coverings, with fascia of temporalis muscle in 2 patients, with lyodura in 6 patients, with fascia lata in 15 patients but 21 coverings. In 4 patients the dura wounds were sutured by interrupted sutures. The best results were obtained in the fascia lata group.
在1991年7月至1992年1月的7个月期间，我院收治了69例穿透性头部战伤患者。硬脑膜的导弹伤在大多数情况下需要紧急手术治疗：严密缝合硬脑膜缺损。然而，对于修复导弹所致硬脑膜缺损的最佳材料仍存在两难选择。有几种可能性：自体替代物，如取自周围的骨膜（颅骨膜）、颞肌筋膜、阔筋膜，或同种异体移植，如冻干硬脑膜（lyodura）。在这69例患者中，7例采用保守治疗，13例接受了手术治疗，但因病情危急未缝合硬脑膜伤口，在45例接受手术治疗的患者中，53次移植覆盖了硬脑膜缺损：22例患者使用骨膜覆盖，但有24次覆盖；2例患者使用颞肌筋膜覆盖；6例患者使用冻干硬脑膜覆盖；15例患者使用阔筋膜覆盖，但有21次覆盖。4例患者的硬脑膜伤口采用间断缝合。阔筋膜组取得了最佳效果。
