Yamagata S, Goto K, Oda Y, Kikuchi H
Department of Neurosurgery, Kyoto University School of Medicine, Japan.
Neurol Med Chir (Tokyo). 1993 Aug;33(8):582-5. doi: 10.2176/nmc.33.582.
Dural repair using chemically treated cadaveric dura mater often results in atrophic and fragile change of the substitute as well as adhesion between the dura mater and brain surface at reoperation. Creutz-feldt-Jakob disease has occurred after repair using cadaveric dura mater. Expanded polytetrafluoroethylene (EPTFE) surgical sheet was used for dural repair in 34 patients. Suturing of EPTFE was easy and the incidence of cerebrospinal fluid accumulation in the epidural space was the same as when cadaveric dura mater was used. Six patients underwent reoperation, 1-15 months after the first operation. At reoperation the EPTFE sheet showed no change except for becoming transparent, and the strength was well preserved. A very thin layer of granulation tissue was formed between the EPTFE sheet and brain surface, but the EPTFE sheet was easily detached from the brain surface without adhesion even 15 months after the first operation. Our results suggest that the EPTFE sheet can be used safely and effectively as an artificial dura mater.
使用化学处理的尸体硬脑膜进行硬脑膜修复，常常会导致替代物出现萎缩和脆弱变化，以及再次手术时硬脑膜与脑表面之间发生粘连。使用尸体硬脑膜修复后曾发生克雅氏病。34例患者使用膨体聚四氟乙烯（EPTFE）手术片进行硬脑膜修复。EPTFE的缝合很容易，硬膜外间隙脑脊液积聚的发生率与使用尸体硬脑膜时相同。6例患者在首次手术后1至15个月接受了再次手术。再次手术时，EPTFE片除了变得透明外无变化，且强度保存良好。EPTFE片与脑表面之间形成了一层非常薄的肉芽组织，但即使在首次手术后15个月，EPTFE片也很容易从脑表面分离，未发生粘连。我们的结果表明，EPTFE片可作为人工硬脑膜安全有效地使用。
