Outcome of Duralplasty With Fascia Lata Graft For Dural Defects

Aurangzeb Kalhoro, Kashif Ahmed, Abdul Sattar Hashim

Abstract

Objective

To assess the outcome of duralplasty with fascia lata graft for dural defects in neurosurgical procedures.

Study design Descriptive case series.

Place & Duration of study

Department of Neurosurgery at Neurospinal & Cancer Care Institute Karachi, from April 2020 to April 2024.

Methods

Fascia lata was used as a dural substitute because of the insufficient tissues available in the adjacent region in patients who underwent surgical procedures due to trauma, brain tumors, infections or cerebrospinal fluid (CSF) leak. The data collected included demographic characters, clinical presentation, location of the pathology, operative procedures done, graft size, postoperative CSF leakage, meningitis, wound infection and donor site complications. Descriptive statistics were used to present the data.

Results •

Duraplasty with fascia lata was done in 61 patients. This included 42 (68.8%) males and 19 (31.2%) females. The age was from 15 - 62 years with the mean age of 38±10 years. The size of the grafts applied varied from 3.5 cm × 7 cm to 6 cm × 8 cm. Operative indications included gunshot wound and trauma in 30 (49.1%) patients, tumor in 14 (22.9%), cerebrospinal fluid fistula in 10 (16.4%) and post-infection in 7 (11.4%) patients. Twenty (32.7%) procedures were done in emergency. The mean duration of the operative procedure was 145±25 minutes. The most common surgical sites for dural repair were the frontal region (n=21 - 34.4%), followed by the parietal (n=18 - 29.5%), and occipital (n=12 - 19.6%) regions. Three (4.9%) patients developed postoperative CSF leakage. Four (6.5%) patients expired in this series.

Conclusion

Fascia lata graft was effective and readily available dural substitute in reconstruction of the large defects with minimal complication in our patients. Moreover, the secondary incision which was necessary for the harvesting the graft did not add to the major morbidity.

Key words

Fascia lata, Dura defects, Brain trauma, Brain tumor. Cerebrospinal fluid.