Localized controlled fibrin glue application with gelatin sponge for hemostasis and dural defect repair: Technical note

Yasunori Nagahama; Luyuan Li; Masaaki Takeda; Takafumi Mitsuhara; Kaoru Kurisu; Matthew A Howard; Patrick W Hitchon; Satoshi Yamaguchi

doi:10.1016/j.inat.2019.100476

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Localized controlled fibrin glue application with gelatin sponge for hemostasis and dural defect repair: Technical note

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Localized controlled fibrin glue application with gelatin sponge for hemostasis and dural defect repair: Technical note

Yasunori Nagahama, Luyuan Li, Masaaki Takeda, Takafumi Mitsuhara, Kaoru Kurisu, Matthew A Howard, Patrick W Hitchon and Satoshi Yamaguchi

Interdisciplinary neurosurgery : Advanced techniques and case management, Vol.18, p.100476

12/2019

DOI: 10.1016/j.inat.2019.100476

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Abstract

Hemostasis and dural defect repair are fundamental aspects of neurosurgical procedures. Some significant bleeding may be caused by dural tears (e.g. bleeding from cerebral dural venous sinuses). Various methods have been previously reported for these purposes, utilizing commercially available surgical materials such as gelatin sponge and fibrin glue. We describe a simple, yet versatile and flexible technique with a critical modification to the previously known combined use of gelatin sponge and fibrin glue. We then present a few illustrative cases and discuss the utility and advantages of the described technique. The described technique involves separate and sequential application of fibrinogen solution followed by thrombin solution of fibrin glue over gelatin sponge, which enables hemostasis or dural defect repair in a localized, controlled manner. We have utilized this technique effectively for hemostasis and dural defect repair in a variety of neurosurgical procedures for over 10 years. We have found the technique to be highly useful and effective, although the effectiveness of this technique may be difficult to quantify objectively and independently of the other standard surgical maneuvers, given that hemostasis and prevention of cerebrospinal fluid leak is multifactorial. We have not encountered any complications specifically attributable to the use of fibrin glue and/or gelatin sponge for this technique. This technique will add to the neurosurgeons' arsenal for hemostasis and dural defect repair, in addition to the more standard and basic surgical maneuvers. •Hemostasis and dural defect repair are fundamental processes in neurosurgical procedures.•Various methods have been previously reported for these purposes, utilizing gelatin sponge and fibrin glue.•We describe a technique involving separate application of fibrinogen and thrombin of fibrin glue over gelatin sponge•This is a simple, yet versatile and flexible technique for focal and controlled hemostasis and dural defect repair•This technique is novel and unique, and can be effectively utilized, in addition to the more standard surgical maneuvers.

CSF leak

Dural closure

Cerebral dural venous sinus

Fibrin sealant

Tisseel

Gelfoam

Details

Title: Subtitle: Localized controlled fibrin glue application with gelatin sponge for hemostasis and dural defect repair: Technical note
Creators: Yasunori Nagahama - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Luyuan Li - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Masaaki Takeda - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
Takafumi Mitsuhara - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
Kaoru Kurisu - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
Matthew A Howard - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Patrick W Hitchon - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Satoshi Yamaguchi - Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Interdisciplinary neurosurgery : Advanced techniques and case management, Vol.18, p.100476
DOI: 10.1016/j.inat.2019.100476
ISSN: 2214-7519
eISSN: 2214-7519
Publisher: Elsevier B.V
Language: English
Date published: 12/2019
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Neurology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984040559002771

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