Efficacy and safety of decompressive craniectomy with non-suture duraplasty in patients with traumatic brain injury

Background Decompressive craniectomy is an important surgical treatment for patients with severe traumatic brain injury (TBI). Several reports have been published on the efficacy of non-watertight sutures in duraplasty performed in decompressive craniectomy. This study aims to evaluate the effectiveness of dura closure without sutures (non-suture duraplasty) in decompressive craniectomy for TBI. Methods One hundred and six patients were enrolled at a single trauma center between January 2017 and December 2018. We retrospectively collected the data and classified the patients into non-suture and suture duraplasty craniectomy groups. We compared the characteristics of patients and their intra/post- operative findings such as operative time, blood loss, imaging findings, complications, and Glasgow outcome scale. Results There were 37 patients in the non-suture group and 69 in the suture craniectomy group. There were no significant differences between the two groups with regard to general characteristics. The operative time was 205 min for the suture duraplasty group and 150 min for the non-suture duraplasty group, and that for the non-suture duraplasty group was significantly lesser (p=0.002). Blood loss was significantly lesser in the non-suture duraplasty group (1000 mL) than in the suture duraplasty group (1500 mL, p=0.028). There were no other significant differences. Conclusion Non-suture duraplasty involved shorter operative time and lesser blood loss when compared to suture duraplasty. Other complications and prognosis were similar in both groups. Therefore, it can be concluded that decompressive craniectomy with non-suture duraplasty is a safe and useful surgical technique in patients with TBI.