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ROLE OF DURAL TENTING SUTURES IN PREVENTING EDH IN ROUTINE SURGERY

ROLE OF DURAL TENTING SUTURES IN PREVENTING EDH IN ROUTINE SURGERY. DEEPAK AGRAWAL, BS SHARMA, VS MEHTA Deptt. Of Neurosurgery, AIIMS New Delhi. DURAL TENTING SUTURES. Walter Dandy (1932)

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ROLE OF DURAL TENTING SUTURES IN PREVENTING EDH IN ROUTINE SURGERY

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  1. ROLE OF DURAL TENTING SUTURES IN PREVENTING EDH IN ROUTINE SURGERY DEEPAK AGRAWAL, BS SHARMA, VS MEHTA Deptt. Of Neurosurgery, AIIMS New Delhi

  2. DURAL TENTING SUTURES • Walter Dandy (1932) “A NUMBER OF PERMANENT SILK SUTURES TIGHTLY DRAWN BETWEEN THE DURA AND THE GALEA OR SUBAPONEUROTIC TISSUE…[WILL] HOLD THE DURA FIRMLY AGAINST THE BONE AND MAKE POSTOP EDH FROM THIS SOURCE IMPOSSIBLE” AIIMS 2002

  3. WHAT IS THE NEED OF THIS STUDY? AIIMS 2002

  4. The use of dural tenting sutures today is a perpetuation of a tradition introduced 70 years back. • Pts were hypotensive • Blood was not replaced • Minimal monitoring of cardiovascular status AIIMS 2002

  5. DURAL TENTING SUTURES • Era of evidence based medicine • Conditions like significant systemic hypotension almost nonexistentent now • Possibility of causing bleeding from dural or cerebral vessels is present • Slightly longer operating time AIIMS 2002

  6. AIM: • TO ASSESS THE EFFICACY OF DURAL TENTING SUTURES IN PREVENTING POSTOP EDH FORMATION FOLLOWING ELECTIVE SUPRATENTORIAL CRANIOTOMY AIIMS 2002

  7. MATERIALS AND METHODS • PROSPECTIVE RANDOMISED STUDY • JUL 2001 TO JUNE 2002 AIIMS 2002

  8. MATERIALS & METHODS AIIMS 2002

  9. HOWEVER, ALL PTS IN WHICH THE SURGEON FELT THERE WAS NEED FOR HITCH SUTURES WERE EXCLUDED FROM THE STUDY AND NOT RANDOMISED AIIMS 2002

  10. RESULTS (Sex distribution) AIIMS 2002

  11. AIIMS 2002

  12. TYPE OF SURGERY AIIMS 2002

  13. OUTCOME AIIMS 2002

  14. CONCLUSIONS • DURAL TENTING SUTURES ARE SUPERFLUOUS IN ROUTINE SUPRATENTENTORIAL CRANIOTOMY AIIMS 2002

  15. THANK YOU AIIMS 2002

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