Use of Large Fascia Lata Graft as Dural Substitute in Neurosurgical Procedures at Neurosurgery Department Teaching Hospital D G Khan

  • Iqbal Ahmad Kharal Department of Neurosurgery GKMC and Teaching Hospital,
  • ASIM BHATTI Surgery, Ghazi Khan Medical College and Teaching Hospital Dera Ghazi Khan
  • SAMIA SAEED Department of 1Neurosurgery
  • Sajjad Ahmad Department of 1Neurosurgery
Keywords: CSF Fistula,, Dural Repair

Abstract

Introduction: Allogeneic grafts and other synthetic materials are being successfully used in dural grafting procedures. However, autologous resources including temporoparietal fascia, pericranium, peritoneum, and fascia lata provide an alternate substitute.' The use of fascia lata is the source of choice especially when large tissue is needed.
Materials and Methods: We present 21 cases 24 (75%) male, 7 (25%) female patients (age between 10 to 60 years) in which fascia lata was used for dural substitute when there was inadequate regional tissue, such as pericranium or temporalis fascia to repair the dural defect from May 2014 to April 2015, were analyzed retrospectively. Operative indications included in gunshot wound &head trauma 14 patients (50%), tumor in eight (28.5%), cerebrospinal fluid fistula in four (14.5%), infection in two (7.0%). This was a retrospective study and ethical approval was obtained from institutional ethical board. Department of Neurosurgery treated twenty eight patients in which fascia lata was used for dural substitute when there was inadequate regional tissue, such as pericranium or temporalis fascia to repair the dural defect from May 2014 to April 2016.
Results: The grafts' dimensions were from 4 × 8 cm to 8 × 18 cm. Clinical and radiologic follow-up was perfor-med up to year after surgery. There were very limited significant complications related to the fascia lata grafting (in terms of cerebrospinal fluid leakage, meningitis, and wound infection. Two patients presented post-operative CSF leakage and were treated by percutaneous lumbar drainage. All patients improved completely, requiring no additional treatment. In few cases infection was either systemic or local, but required long-term and broad-spectrum antibiotic regimen.
Conclusion: Fascia lata is relatively simple and effective dural substitute for larger defects without any significant complications in our patients.

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Published
2018-10-04
Section
Original Articles