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Journal of Korean Neurosurgical Society 1993;22(11): 1167-1174.
Experimental Trial for the Prevention of Adhesion with Dural Substitutes in Craniectomy State.
Young Jo Cha, Si Hun Song, Seong Ho Kim, Kwan Tae Kim, Youn Kim
Department of Neurosurgery, College of Medicine, Chung-Nam National University, Daejon, Korea.
In a series of rabbits, two craniectomies were made in both side of the parietal hone. Each lesion was filled with gelfoam, lyocura, fat and dural film. Five rabbits were left empty as a control group. The animals were killed in one month after the operation. The degree of adhesion between the soft tissue of the scalp and various dural substitute was evaluated at the time of operative dissection and studied histopathologically. The results were as follows. 1) The insertion of dural substituted substances can prevent the adhesion between the scalp and dura mater. 2) The dural film was most effective in prevention of adhesion. 3) The dural film inserted group exhibited inflammatory reaction. 4) The gelfoam, lyodura and fat inserted groups were though to have had a moderate prevention effect of adhesion. With these results, we could conclude that the insertion of material between the dura and scalp can prevent adhesion. However the ideal inserted material which can pevent inflammatory reaction and adhesion has not been determined. At this point we have not found and ideal substitute. To get an ideal material for prevention of adhesion, further intensive study is required.
Key Words: Craniectomy; Adhesion; Dural substitute; Adhesion Index
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