If a watertight seal cannot be obtained, a hydrogel or a fibrin sealant will immediately improve the strength of repair. There was an 80% reduction in leak area with the hydrogel and cyanoacrylic sealants compared with only a 38% reduction with fibrin glue however, there was no statistical difference between the leak rates using any of the sealants.Ħ-0 Prolene using either interrupted or locked techniques was the best at creating watertight closure of an incidental durotomy. In most cases, leakage occurred from the needle holes around sutures. We found no significant differences in the flow rate between the interrupted and continuous locked sutures. The study was funded from an intramural departmental grant.Ħ-0 Prolene was found to have significantly decreased leakage flow rate than 5-0 surgilon. The percent reduction of leak area was determined for the sealants and compared using ANOVA. The leakage flow rate was compared among suture groups using analysis of variance (ANOVA). We compared surgical repair between 5-0 surgilon and 6-0 prolene suture, continuous locked versus interrupted suture, and the effectiveness of three adhesives hydrogel, cyanoacrylate, and fibrin glue. To compare the hydrostatic strength of dural repair using various suture sizes, closure techniques, and adhesives.Ī novel in vitro hydrostatic calf spine model.ĭural leakage as a function of hydrostatic pressure and leak area. This is treated with watertight suture repair, often combined with a sealant. Incidental durotomy occurs in 1% to 17% of lumbar spine surgery.
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