ゴアテックス®人工硬膜の縫合固定法に関する実験的研究—髄液漏を防ぐための工夫

Experimental Study of Water Leakage in Duraplasty Using ePTFE Sheet as an Artificial Dura Mater

I．はじめに

　本邦では乾燥死体硬膜の使用が全面的に禁止され，これに代わりゴアテックス^®人工硬膜（Expanded Polytetrafluoroethylene sheet，以下ePTFE）が普及している．しかし，ePTFEは収縮性が無いため，縫合針によりできた針穴がそのまま残ることから術後に髄液漏を生じることがある^4）．そこで今回われわれはどのような縫合固定法がもっとも髄液漏を予防できるかを実験的に検討した．

　The authors have evaluated the preventive effect of water leakage from the suture holes of expandedpolytetrafluoroethylene (ePTFE) sheet. Six currently available suture materials (4-0 SURGILON, 4 typesof Gore-tex suture, DuraClose) were compared.

　The water leakage was 0.05cc/min when using Gore-tex suture (CV-6, needle/thread ratio=1.0), 0.025cc/min when using DuraClose. With each two material, the water leakage was significantly less (p＜0.05) in comparison with other materials. Scanning electron microscopic examination revealed that the residual suture holes were minimum when using Gore-tex suture (CV-6, needle/thread ratio=1.0).

　In conclusion, running suture with Gore-tex suture (CV-6, needle/thread ratio=1.0) could be effective inpreventing water leakage from the suture holes of ePTFE sheet in duraplasty.