J Korean Neurosurg Soc.  2013 Oct;54(4):336-339. 10.3340/jkns.2013.54.4.336.

Galeal Tack-Up Sutures to Prevent Subgaleal Cerebrospinal Fluid Collection

• Choi WH
• Moon CT
• Koh YC
• Chun YI
• Cho J
• Song SW

• KMID: 1499340
• DOI: http://doi.org/10.3340/jkns.2013.54.4.336

Abstract

OBJECTIVE
Postoperative subgaleal cerebrospinal fluid (CSF) collection is considered as one of the common minor surgical complication which can lead to prolonged hospitalization. We introduce "galeal tack-up suture" to prevent postoperative subgaleal CSF collection.
METHODS
Galeal tack-up suture consists of various surgical techniques which aim to fix galea to cranium in order to prevent CSF pooling in subgaleal space. A total of 87 patients who underwent craniotomy were divided into two groups while closing the wound : group A with galeal tack-up suture and group B with routine wound closure without galeal tack-up suture. The patients were observed for postoperative subgaleal CSF collection.
RESULTS
Among 87 cranitomy cases, galeal tack-up suture was performed in 32 cases and routine wound closure was done in 55 cases. Postoperative subgaleal CSF collection occurred in 13 cases (15%) in which 12 cases occurred in group B patients and 1 case occurred in group A patients (p=0.026).
CONCLUSION
Galeal tack-up suture is an easy and effective technique in wound closure to prevent postoperative CSF collection.

Keyword

Cerebrospinal fluid leak; Craniotomy; Scalp; Sutures

MeSH Terms

Cerebrospinal Fluid Rhinorrhea
Cerebrospinal Fluid*
Craniotomy
Hospitalization
Humans
Scalp
Skull
Sutures*
Wounds and Injuries

Figure

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  Fig. 1 Three different types of galeal tack-up sutures utilizing A : pair of straight holes burred for dural tenting, B : V-shaped holes, C : cranial plate for bone flap fixation.

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  Fig. 2 Galeal fixation to the cranium with galeal tack-up sutures.

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