Dural dryness makes suturing difficult during dural closure after craniotomy. In this case, dural plasty is often performed using a membrane taken from the surrounding tissue (e.g., fascia or periosteum) or an artificial replacement membrane. Herein, we introduce our novel "roll-up technique" to reduce the utilization of substitute membranes and explore its effectiveness in dural closure. We retrospectively examined the medical records of 50 patients who underwent craniotomy for the first time for supratentorial intracranial lesions between 2015 and 2022. Furthermore, we divided them into two groups: (1) the conventional technique group, which consisted of patients in whom the dura mater was flipped after incision and protected with a moistened gauze (n = 23), and (2) the roll-up technique group, which consisted of patients in whom the dura mater was incised in a U shape, rolled up, and protected with a moist gauze (n = 27). After surgery, we compared the success rates of primary closure, operating time, craniotomy area, and percentage of complications (e.g., cerebrospinal fluid [CSF] leakage or infection) between the groups. Dural closure without dural substitutes using the roll-up technique had a higher success rate than that using the conventional technique (26/27 [96.3%] cases vs. 14/23 [60.9%] cases; P = 0.003). Postoperative CSF leakage or infection did not occur, and no statistically significant difference was observed in the operating time between the groups (P = 0.247). The roll-up technique for dural closure may effectively prevent post-incisional dural shrink after craniotomy.

Yuki YASUOKA

Ushio YONEZAWA

Shinya NABIKA

Takeshi TAKAYASU

Akira TAGUCHI

Naohiko OHBAYASHI

Fumiyuki YAMASAKI

Nobutaka HORIE

Neurologia medico-chirurgica

Neurologia Medico-Chirurgica is a professional journal focused on neurosurgery and related fields, dedicated to publishing high-quality research papers, reviews, and clinical cases to promote advancements and developments in neurology.

《Neurologia Medico-Chirurgica》是一本专注于神经外科和相关领域的专业期刊，致力于发表高质量的研究论文、综述和临床案例，以促进神经医学的进步和发展。

Neurologia Medico-Chirurgica

Preventing Post-incisional Dural Shrink in Craniotomy: Introducing the "Roll-up Technique"

预防开颅术后硬脑膜回缩：介绍“卷起技术”

Category	Quartile
医学	4
医学, 临床神经病学	4
医学, 外科	4

Preventing Post-incisional Dural Shrink in Craniotomy: Introducing the "Roll-up Technique"

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