Large retrospective study of artificial dura substitute in patients with traumatic brain injury undergo decompressive craniectomy

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Background Decompressive craniectomy is widely used for treating patients with traumatic brain injury (TBI). Usually patients have dura mater defect due to surgery or injury itself. The defective area may left open or repaired by artificial dura substitutes. A variety of artificial dura substitutes have been used for this purpose. Objective This study aimed to evaluate bovine‐derived pericardium membrane as artificial dural material for patients with decompressive craniectomy. Methods Totally 387 patients with severeTBIin our hospital were included in this study. Among them, 192 patients were treated with standard decompressive craniectomy without dura repair (control group). One hundred and ninety‐fiveTBIpatients were treated with dura repair by artificial dura materials (ADM). Nonlyophilized bovine pericardium membranes were used as artificial dura material. The postoperative complications were compared in both groups, including infection, seizure, and cerebrospinal fluid (CSF) leakage. Results Patients in control group have higher complication rates than patients inADMgroup, including subcutaneous hematoma (13.02% in control vs. 4.01% inADMgroup,p = .004), infection (12.5% in control vs. 5.64% inADMgroup,p = .021),CSFleakage (13.02% in control vs. 5.13% inADMgroup,p = .012), and seizure (10.42% in control vs. 3.08% inADMgroup,p = .007). Patients inADMgroup are only associated with higher incidence of foreign body reaction (6 of 195 patients inADMvs. none from control group). Conclusion Bovine‐derived pericardium membranes are successfully used as artificial dural substitutes for decompressive craniectomy. Patients withADMhave better clinical outcome than control group.