{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:02:21Z","timestamp":1790564541892,"version":"4.1.0"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,12,6]],"date-time":"2019-12-06T00:00:00Z","timestamp":1575590400000},"content-version":"vor","delay-in-days":715,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2018,10]]},"abstract":"Abstract<\/jats:title>\n \n BACKGROUND<\/jats:title>\n Cerebrospinal fluid (CSF) leakage occurs in 4% to 32% of cranial surgeries and is associated with significant patient burden and expense. The use of sealant as an adjunct to primary dural closure is assumed to help prevent CSF leakage.<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE<\/jats:title>\n To examine the utility of different sealants for dural closure using an in Vitro model.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n We evaluated 9 commonly used dural sealants, including Tachosil (Takeda Inc, Osaka, Japan), Adherus (Hyperbranch Inc, Durham, North Carolina), Duraform (Codman, Raynham, Massachusetts), Tissudura (Baxter, Deerfield, Illinois), Hemopatch (Baxter), TissuePatchDural (Tissuemed, Leeds, United Kingdom), Tisseel (Baxter), Duragen Secure (Integra, Plainsboro, New Jersey), and Duraseal, (Integra). Sealants were tested in 2 novel in Vitro setups using fresh porcine dura: the first tested the acute burst pressure of a sealed 3-mm gap, while the second examined resistance to a pressure wave mimicking intracranial pressure for 72 h.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Adherus showed the highest mean burst pressure (87 \u00b1 47 mmHg) followed by Tachosil (71 \u00b1 16 mmHg) and Duraseal (51 \u00b1 42 mmHg); these were the only 3 sealants showing burst pressures above normal physiological intracranial pressure. In the 72-h setup, only Adherus and Duraseal maintained appropriate sealing for the duration of the experiment. Tachosil released from the dura after 1.4 h (95% confidence interval, \u22121.8-4.7).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n Given the high cost of sealants and the results of this study, we advocate a critical attitude toward sealant application as an adjunct to classic dural closure.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ons\/opx260","type":"journal-article","created":{"date-parts":[[2017,12,21]],"date-time":"2017-12-21T11:27:56Z","timestamp":1513855676000},"page":"425-432","source":"Crossref","is-referenced-by-count":35,"title":["Usefulness of Sealants for Dural Closure: Evaluation in an In Vitro Model"],"prefix":"10.1227","volume":"15","author":[{"given":"Tristan","family":"van Doormaal","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brain Center Rudolph Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands"},{"name":"Brain Technology Institute, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Kinaci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain Center Rudolph Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander","family":"van Thoor","sequence":"additional","affiliation":[{"name":"Brain Technology Institute, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Redegeld","sequence":"additional","affiliation":[{"name":"Brain Technology Institute, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelmina","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"van der Zwan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain Center Rudolph Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands"},{"name":"Brain Technology Institute, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,10]]},"reference":[{"key":"bib1-20231017","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.surneu.2005.03.041","article-title":"Costs of postoperative cerebrospinal fluid leakage: 1-year, retrospective analysis of 412 consecutive nontrauma cases","volume":"64","author":"Grotenhuis","year":"2005","journal-title":"Surg Neurol"},{"key":"bib2-20231017","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.wneu.2011.12.011","article-title":"A multicenter, single-blind, prospective randomized trial to evaluate the safety of a polyethylene glycol hydrogel (Duraseal Dural Sealant System) as a dural sealant in cranial surgery","volume":"78","author":"Osbun","year":"2012","journal-title":"World Neurosurg"},{"key":"bib3-20231017","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1007\/s00701-011-1197-9","article-title":"Study of dural suture watertightness: an in vitro comparison of different sealants","volume":"153","author":"Chauvet","year":"2011","journal-title":"Acta Neurochir"},{"key":"bib4-20231017","first-page":"16","article-title":"Basic concepts about brain pathophysiology and intracranial pressure monitoring","volume":"30","author":"Rodriguez-Boto","year":"2015","journal-title":"Neurologia"},{"key":"bib5-20231017","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1227\/01.NEU.0000138441.07112.1B","article-title":"Suturing technique and the integrity of dural closures: an in vitro study","volume":"55","author":"Megyesi","year":"2004","journal-title":"Neurosurgery"},{"key":"bib6-20231017","first-page":"352","article-title":"Watertight dural closure: is it necessary? A prospective randomized trial in patients with supratentorial craniotomies","volume":"63","author":"Barth","year":"2008","journal-title":"Neurosurgery"},{"key":"bib7-20231017","doi-asserted-by":"crossref","first-page":"735","DOI":"10.3171\/2014.6.JNS131917","article-title":"Risk factors for postoperative CSF leakage after elective craniotomy and the efficacy of fleece-bound tissue sealing against dural suturing alone: a randomized controlled trial","volume":"121","author":"Hutter","year":"2014","journal-title":"J Neurosurg"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/15\/4\/425\/30207501\/opx260.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/01787389-201810000-00015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:49:54Z","timestamp":1786121394000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01787389-201810000-00015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,21]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opx260","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,21]]}}}