The collagen matrix dural substitute graft prevents postoperative cerebrospinal fluid leakage after ventriculoperitoneal shunt surgery in patients aged <1 year

Masanori Sato; Tatsuki Oyoshi; Hirofumi Iwamoto; Natsuko Tanoue; Soichiro Komasaku; Nayuta Higa; Hiroshi Hosoyama; Hiroshi Tokimura; Satoshi Ibara; Ryosuke Hanaya; Koji Yoshimoto

doi:10.25259/SNI_629_2022

The collagen matrix dural substitute graft prevents postoperative cerebrospinal fluid leakage after ventriculoperitoneal shunt surgery in patients aged <1 year

Surg Neurol Int. 2022 Oct 7:13:461. doi: 10.25259/SNI_629_2022. eCollection 2022.

Affiliations

¹ Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University.
² Department of Neurosurgery, Kagoshima City Hospital, Kagoshima, Japan.
³ Department of Neonatology, Kagoshima City Hospital, Kagoshima, Japan.

Abstract

Background: Cerebrospinal fluid (CSF) leakage is a common complication of ventriculoperitoneal shunt (VPS) and has the potential to induce shunt infection. Especially in infants and children, these are serious complications. DuraGen is a collagen matrix dural substitute used to reduce the risk of CSF leakage in various neurosurgeries. We report our VPS procedure with DuraGen for preventing postoperative CSF leakage in patients aged <1 year.

Methods: We used DuraGen to prevent postoperative CSF leakage in six VPS surgeries. Antibiotic-impregnated shunt catheters and programmable valves with anti-siphon devices were also used in all cases. DuraGen was placed inside and atop the burr hole. All cases had an initial shunt pressure of 5 cmH2O. Fibrin glue was not used.

Results: The patients underwent follow-up for a year after VPS surgery. There was no postoperative subcutaneous CSF collection or leakage after all six VPS surgeries. Furthermore, no postoperative shunt infections or DuraGen-induced adverse events were noted.

Conclusion: We speculate that DuraGen has a preventive effect on postoperative CSF leakage in VPS cases aged <1 year.

Keywords: Cerebrospinal fluid leakage; Collagen matrix; Hydrocephalus; Pediatric neurosurgery; Shunt infection; Ventriculoperitoneal shunt.