Matsumoto Yoshihisa, Aikawa Hiroshi, Tsutsumi Masanori, Narita Sumito, Yoshida Hidenori, Etou Housei, Sakamoto Kimiya, Kazekawa Kiyoshi
Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
Neurol Med Chir (Tokyo). 2013;53(1):43-6. doi: 10.2176/nmc.53.43.
Expanded polytetrafluoroethylene (ePTFE) porous material (GORE(®) PRECLUDE(®) Dura Substitute) does not degenerate or deteriorate in vivo, and is currently used as artificial dura mater. This material does not adhere well to the surrounding tissues, but cerebrospinal fluid leakage along the suture line has been observed in several cases. We describe a case of craniotomy for tumor resection performed 14 years after dural repair with ePTFE sheet. Histological examination of the ePTFE sheet revealed that the sheet was structurally intact, with no evidence of tissue adhesion or cellular infiltration. However, collagen deposition was observed around the suture thread. When the suture thread was removed the collagen was also removed, and the original needle hole appeared again. No significant changes were observed in the features of the ePTFE sheet even 14 years postoperatively. The formation of fibrous tissue around the needle hole was important in preventing cerebrospinal fluid leakage.
膨体聚四氟乙烯（ePTFE）多孔材料（戈尔（®）普瑞克鲁德（®）硬脑膜替代物）在体内不会退化或变质，目前用作人工硬脑膜。这种材料与周围组织的粘附性不佳，但在几例病例中已观察到沿缝线处有脑脊液漏出。我们描述了1例在使用ePTFE片进行硬脑膜修复14年后因肿瘤切除而进行开颅手术的病例。对ePTFE片进行组织学检查发现该片结构完整，没有组织粘连或细胞浸润的迹象。然而，在缝线周围观察到胶原沉积。当缝线拆除时，胶原也被去除，原来的针孔再次出现。即使在术后14年，ePTFE片的特征也未观察到明显变化。针孔周围纤维组织的形成对于预防脑脊液漏出很重要。
