Hemopatch ® as a new dural sealant: A clinical observation.

OBJECTIVES: We analyzed our results using Hemopatch® as a new dural sealant after durotomy in cranial and spinal neurosurgical procedures.

PATIENTS AND METHODS: In our prospective single center study, we analyzed all patients who received Hemopatch® used as a dural sealant between October 2016 and May 2017. 34 patients received Hemopatch® used as a dural sealant in the study period. We included 23 (67.6%) female and 11 (32.3%) male patients. The mean age was 56 years (4-83 years). We included emergency and elective surgical procedures as well as spinal and cranial intradural surgery. We did not exclude any type of underlying pathology. We took note of the general patient data, the size of Hemopatch® used, the type of dural closure, and the postoperative stay. Additionally, we recorded the type of dural closure (watertight/ watertight with additional muscle patch/ not watertight with small or large defect (>1 cm) remaining) and of preoperative hydrocephalus as well as intraoperative ventricular opening.

RESULTS: Hemopatch® was used in addition to the following dural closures: 11 (32.4%) watertight suture, 23 (67.6%) non-watertight suture. Three (8.8%) surgeries were emergency procedures. The site of surgery was as follows: 18 (52.9%) supratentorial, 16 (47.1%) infratentorial. A ventricular opening was performed in 13 (38.2%) cases. A hydrocephalus was present in 2 (5.9%) cases. A revision surgery after use of Hemopatch® was performed in 2 (5.9%) patients. Postoperative CSF fistulas and infections were observed in 2 patients each.

CONCLUSION: We could demonstrate the safety and efficiency of Hemopatch® used as dural sealant after durotomy in microneurosurgical procedures. To confirm our promising results a larger prospective randomized controlled trial will be needed.