Harvest of autologous clavipectoral fascia for use in duraplasty: Cadaveric feasibility study

Robert G. Louis, R. Shane Tubbs, Martin M. Mortazavi, Mohammadali M. Shoja, Marios Loukas, Aaron Cohen-Gadol

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Techniques and materials for repair of dural defects following neurosurgical procedures vary. Given higher complication rates with nonautologous duraplasty materials, most authors strongly recommend autologous grafts. To expand the arsenal of possible materials available to the neurosurgeon, we propose the use of autologous clavipectoral fascia as an alternative donor for duraplasty. Eight embalmed adult cadavers underwent dissection of the pectoral region. A 12-cm curvilinear skin incision was made 2 cm inferior to the nipple in males and along the inferior breast edge in females. Dissection was continued until the clavipectoral fascia was encountered, and a tissue plane was developed between this fascia and the deeper pectoralis major muscle. Sections of clavipectoral fascia were used for duraplasty in the same specimens. In all specimens, removal of clavipectoral fascia was easily performed with tissue separation between the overlying fascia and underlying muscle. Only small adhesions were found between the fascia and underlying muscle, and these were easily transected. No obvious gross neurovascular injuries were identified. Large portions of clavipectoral fascia were available, and at least a 10 × 10-cm piece (average thickness, 1.2 mm) was easily harvested for all specimens. Clavipectoral fascia shares characteristics with materials such as pericranium and fascia lata that have been used successfully in duraplasty, and most importantly, it is autologous. Theoretically, using clavipectoral fascia would reduce the risk of muscle herniation. It offers an alternative source for autologous dural grafting when other sources are unavailable or exhausted. Clinical experience with this fascia is warranted.

Original languageEnglish
Pages (from-to)619-621
Number of pages3
JournalJournal of Craniofacial Surgery
Volume24
Issue number2
DOIs
StatePublished - Mar 2013

Fingerprint

Fascia
Feasibility Studies
Muscles
Dissection
Pectoralis Muscles
Fascia Lata
Neurosurgical Procedures
Nipples
Cadaver
Breast
Tissue Donors
Transplants
Skin

Keywords

  • Clavipectoral fascia
  • Dural graft
  • Dural substitute
  • Duraplasty
  • Fascia lata

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Harvest of autologous clavipectoral fascia for use in duraplasty : Cadaveric feasibility study. / Louis, Robert G.; Tubbs, R. Shane; Mortazavi, Martin M.; Shoja, Mohammadali M.; Loukas, Marios; Cohen-Gadol, Aaron.

In: Journal of Craniofacial Surgery, Vol. 24, No. 2, 03.2013, p. 619-621.

Research output: Contribution to journalArticle

Louis, Robert G. ; Tubbs, R. Shane ; Mortazavi, Martin M. ; Shoja, Mohammadali M. ; Loukas, Marios ; Cohen-Gadol, Aaron. / Harvest of autologous clavipectoral fascia for use in duraplasty : Cadaveric feasibility study. In: Journal of Craniofacial Surgery. 2013 ; Vol. 24, No. 2. pp. 619-621.
@article{c7580a33965f4912944989eeec7f0ce8,
title = "Harvest of autologous clavipectoral fascia for use in duraplasty: Cadaveric feasibility study",
abstract = "Techniques and materials for repair of dural defects following neurosurgical procedures vary. Given higher complication rates with nonautologous duraplasty materials, most authors strongly recommend autologous grafts. To expand the arsenal of possible materials available to the neurosurgeon, we propose the use of autologous clavipectoral fascia as an alternative donor for duraplasty. Eight embalmed adult cadavers underwent dissection of the pectoral region. A 12-cm curvilinear skin incision was made 2 cm inferior to the nipple in males and along the inferior breast edge in females. Dissection was continued until the clavipectoral fascia was encountered, and a tissue plane was developed between this fascia and the deeper pectoralis major muscle. Sections of clavipectoral fascia were used for duraplasty in the same specimens. In all specimens, removal of clavipectoral fascia was easily performed with tissue separation between the overlying fascia and underlying muscle. Only small adhesions were found between the fascia and underlying muscle, and these were easily transected. No obvious gross neurovascular injuries were identified. Large portions of clavipectoral fascia were available, and at least a 10 × 10-cm piece (average thickness, 1.2 mm) was easily harvested for all specimens. Clavipectoral fascia shares characteristics with materials such as pericranium and fascia lata that have been used successfully in duraplasty, and most importantly, it is autologous. Theoretically, using clavipectoral fascia would reduce the risk of muscle herniation. It offers an alternative source for autologous dural grafting when other sources are unavailable or exhausted. Clinical experience with this fascia is warranted.",
keywords = "Clavipectoral fascia, Dural graft, Dural substitute, Duraplasty, Fascia lata",
author = "Louis, {Robert G.} and Tubbs, {R. Shane} and Mortazavi, {Martin M.} and Shoja, {Mohammadali M.} and Marios Loukas and Aaron Cohen-Gadol",
year = "2013",
month = "3",
doi = "10.1097/SCS.0b013e31827c817b",
language = "English",
volume = "24",
pages = "619--621",
journal = "Journal of Craniofacial Surgery",
issn = "1049-2275",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Harvest of autologous clavipectoral fascia for use in duraplasty

T2 - Cadaveric feasibility study

AU - Louis, Robert G.

AU - Tubbs, R. Shane

AU - Mortazavi, Martin M.

AU - Shoja, Mohammadali M.

AU - Loukas, Marios

AU - Cohen-Gadol, Aaron

PY - 2013/3

Y1 - 2013/3

N2 - Techniques and materials for repair of dural defects following neurosurgical procedures vary. Given higher complication rates with nonautologous duraplasty materials, most authors strongly recommend autologous grafts. To expand the arsenal of possible materials available to the neurosurgeon, we propose the use of autologous clavipectoral fascia as an alternative donor for duraplasty. Eight embalmed adult cadavers underwent dissection of the pectoral region. A 12-cm curvilinear skin incision was made 2 cm inferior to the nipple in males and along the inferior breast edge in females. Dissection was continued until the clavipectoral fascia was encountered, and a tissue plane was developed between this fascia and the deeper pectoralis major muscle. Sections of clavipectoral fascia were used for duraplasty in the same specimens. In all specimens, removal of clavipectoral fascia was easily performed with tissue separation between the overlying fascia and underlying muscle. Only small adhesions were found between the fascia and underlying muscle, and these were easily transected. No obvious gross neurovascular injuries were identified. Large portions of clavipectoral fascia were available, and at least a 10 × 10-cm piece (average thickness, 1.2 mm) was easily harvested for all specimens. Clavipectoral fascia shares characteristics with materials such as pericranium and fascia lata that have been used successfully in duraplasty, and most importantly, it is autologous. Theoretically, using clavipectoral fascia would reduce the risk of muscle herniation. It offers an alternative source for autologous dural grafting when other sources are unavailable or exhausted. Clinical experience with this fascia is warranted.

AB - Techniques and materials for repair of dural defects following neurosurgical procedures vary. Given higher complication rates with nonautologous duraplasty materials, most authors strongly recommend autologous grafts. To expand the arsenal of possible materials available to the neurosurgeon, we propose the use of autologous clavipectoral fascia as an alternative donor for duraplasty. Eight embalmed adult cadavers underwent dissection of the pectoral region. A 12-cm curvilinear skin incision was made 2 cm inferior to the nipple in males and along the inferior breast edge in females. Dissection was continued until the clavipectoral fascia was encountered, and a tissue plane was developed between this fascia and the deeper pectoralis major muscle. Sections of clavipectoral fascia were used for duraplasty in the same specimens. In all specimens, removal of clavipectoral fascia was easily performed with tissue separation between the overlying fascia and underlying muscle. Only small adhesions were found between the fascia and underlying muscle, and these were easily transected. No obvious gross neurovascular injuries were identified. Large portions of clavipectoral fascia were available, and at least a 10 × 10-cm piece (average thickness, 1.2 mm) was easily harvested for all specimens. Clavipectoral fascia shares characteristics with materials such as pericranium and fascia lata that have been used successfully in duraplasty, and most importantly, it is autologous. Theoretically, using clavipectoral fascia would reduce the risk of muscle herniation. It offers an alternative source for autologous dural grafting when other sources are unavailable or exhausted. Clinical experience with this fascia is warranted.

KW - Clavipectoral fascia

KW - Dural graft

KW - Dural substitute

KW - Duraplasty

KW - Fascia lata

UR - http://www.scopus.com/inward/record.url?scp=84878488676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878488676&partnerID=8YFLogxK

U2 - 10.1097/SCS.0b013e31827c817b

DO - 10.1097/SCS.0b013e31827c817b

M3 - Article

C2 - 23524759

AN - SCOPUS:84878488676

VL - 24

SP - 619

EP - 621

JO - Journal of Craniofacial Surgery

JF - Journal of Craniofacial Surgery

SN - 1049-2275

IS - 2

ER -