Safety and efficacy of a novel polyethylene glycol hydrogel sealant for watertight dural repair

Author:

Cosgrove G. Rees1,Delashaw Johnny B.2,Grotenhuis J. Andre3,Tew John M.4,van Loveren Harry5,Spetzler Robert F.6,Payner Troy7,Rosseau Gail8,Shaffrey Mark E.9,Hopkins L. Nelson10,Byrne Richard11,Norbash Alex12

Affiliation:

1. 1Massachusetts General Hospital, Boston, Massachusetts

2. 2Oregon Health Sciences University, Portland, Oregon

3. 3Radboud University Medical Center, Nijmegen, The Netherlands

4. 4University of Cincinnati, Mayfield Clinic, Cincinnati, Ohio

5. 5University of South Florida, Tampa General Hospital, Tampa, Florida

6. 6Barrow Neurological Institute, Phoenix, Arizona

7. 7Indianapolis Neurosurgical Group, Inc., Indianapolis, Indiana

8. 8Chicago Institute of Neurosurgery and Neuroresearch, Chicago, Illinois

9. 9University of Virginia Health Systems, Charlottesville, Virginia

10. 10Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, University at Buffalo, New York

11. 11Rush University Medical Center, Chicago, Illinois and

12. 12Boston Medical Center, Boston, Massachusetts

Abstract

Object The authors prospectively evaluated the safety and efficacy of a novel polyethylene glycol (PEG) hydrogel sealant in patients undergoing elective cranial surgery with documented cerebrospinal fluid (CSF) leakage after sutured dural repair. Methods The PEG hydrogel sealant was used at 11 different study sites in 111 patients with documented intraoperative CSF leakage after neurosurgical dural repair for a variety of conditions. Intraoperative CSF leakage was either spontaneous or induced by a Valsalva maneuver. Patients were monitored for 3 months postoperatively with physical examinations, clinical laboratory analyses, and diagnostic imaging. The PEG hydrogel sealant was 100% effective in stopping CSF leakage in all patients. There were no sealant-related adverse events and all clinical outcomes were consistent with expectations for seriously ill patients undergoing prolonged neurosurgical procedures. Conclusions The PEG hydrogel sealant provides a safe and effective watertight closure when used as an adjunct to sutured dural repair during cranial surgery.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

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