{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:47:53Z","timestamp":1772110073642,"version":"3.50.1"},"reference-count":7,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T00:00:00Z","timestamp":1467590400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Posterior fossa surgery is demanding and hides a significant number of obstacles starting from the approach to the wound closure. The risk of cerebrospinal fluid (CSF) leakage in posterior fossa surgery given in the literature is around 8%. The present study aims to introduce a sandwich closure of the dura in posterior fossa surgery, which reduces significantly the number of CSF leaks (3.8%) in the patients treated in our department. Three hundred and ten patients treated in our hospital in the years 2009-2013 for posterior fossa pathologies were retrospectively evaluated. The dura closure method was as following: lyophilized dura put under the dura and sealed with fibrin glue and sutures, dura adapting stitches, TachoSil\u00ae (Takeda Pharma A\/S, Roskilde, Denmark), Gelfoam\u00ae (Pfizer Inc., New York, NY, USA) and polymethylmethacrylate (osteoclastic craniotomy). The incidence of postsurgical complications associated with the dural closure like CSF leakage, infections, bleeding is evaluated. Only 3.8% of patients developed CSF leakage and only 0.5% needed a second surgery for CSF leakage closure. Two percent had a cerebellar bleeding with no need for re-operation and 3% had a wound infection treated with antibiotics. The sandwich wound closure we are applying for posterior fossa surgery in our patients correlates with a significant reduction of CSF leaks compared to the literature.<\/jats:p>","DOI":"10.4081\/cp.2016.824","type":"journal-article","created":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T14:10:26Z","timestamp":1467641426000},"page":"824","source":"Crossref","is-referenced-by-count":8,"title":["Sandwich Wound Closure Reduces the Risk of Cerebrospinal Fluid Leaks in Posterior Fossa Surgery"],"prefix":"10.3390","volume":"6","author":[{"given":"Verena","family":"Heymanns","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abidemi W.","family":"Oseni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameer","family":"Alyeldien","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Homajoun","family":"Maslehaty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Parvin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Scholz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios K.","family":"Petridis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,7,4]]},"reference":[{"key":"ref1","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 (Wien)"},{"key":"ref2","first-page":"ONS182","article-title":"Polyethylene glycol hydrogel dural sealant may reduce incisional cerebrospinal fluid leak after posterior fossa surgery","volume":"63","author":"Than","year":"2008","journal-title":"Neurosurgery"},{"key":"ref3","first-page":"28","article-title":"Postoperative complications associated with dural substitures in suboccipital craniotomies","volume":"64","author":"Moskowitz","year":"2009","journal-title":"Neurosurgery"},{"key":"ref4","first-page":"ONS302","article-title":"Augmented autologous pericranium duraplasty in 100 posterior fossa surgeries-a retrospective case series","volume":"71","author":"Lam","year":"2012","journal-title":"Neurosurgery"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1159\/000272030","article-title":"Management of cerebrospinal fluid leak following retrosigmoid posterior cranial fossa surgery","volume":"71","author":"Bayazit","year":"2009","journal-title":"ORL J Otorhinolaryngol Relat Spec"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4103\/2152-7806.146154","article-title":"Two alternative dural sealing techniques in posterior fossa surgery: (polylactide-co-glycolide) self adhesive resorbable membrane versus polyethylene glycol hydrogel","volume":"5","author":"Schianriti","year":"2014","journal-title":"Surg Neurol Int"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1179\/1743132811Y.0000000042","article-title":"Cerebrospinal fluid leak after microsurgical surgery in vestibular schwanommas via retrosigmoidal craniotomy","volume":"33","author":"Arlt","year":"2011","journal-title":"Neurol Res"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.clinicsandpractice.org\/index.php\/cp\/article\/viewFile\/824\/710","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.mdpi.com\/2039-7283\/6\/2\/824\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T06:36:17Z","timestamp":1644474977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/6\/2\/824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,4]]},"references-count":7,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2016,4]]}},"alternative-id":["cp.2016.824"],"URL":"https:\/\/doi.org\/10.4081\/cp.2016.824","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,4]]}}}