Dural tenting [Neurosurgery Wiki]

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====== Dural tenting ======

{{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/16cUU5Jcud0CSYSmGi2Z7L8NQqpB1dzcl0hvx3fLDnthiqNwcL/?limit=15&utm_campaign=pubmed-2&fc=20240122150049}}


There is a debate on the relevance of dural tenting sutures to the reduction of postoperative epidural hemorrhage
((Swayne OB, Horner BM, Dorward NL. The hitch stitch: an obsolete neurosurgical technique? Br J Neurosurg. 2002 Dec;16(6):541-4; discussion 544. PMID: 12617233.))
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Walter Dandy reported [[dural tenting]] sutures as an effective way to prevent postoperative EDH. Over time, his technique gained in popularity and significance to finally become a neurosurgical standard. Yet, several retrospective reports and one prospective report have questioned the ongoing need for dural tenting sutures. Dandy's explanation that the hemostasis observed under hypotensive conditions is deceiving and eventually causes EDH may be obsolete. Today, proper intra- and postoperative care, including maintenance of normovolemia and normotension and the use of modern hemostatic agents, may be sufficient for effective hemostasis. Thus, there is a fundamental need to evaluate the necessity of dural tenting sutures in a solid, unbiased, evidence-based manner
((Kunert P, Przepiórka Ł, Fortuniak J, Wiśniewski K, Bobeff EJ, Larysz P, Kruk R, Kulesza B, Szczepanek D, Ładziński P, Żyłkowski J, Kujawski S, Łabędzka K, Jaskólski D, Rola R, Trojanowski T, Marchel A. Prophylactic use of dural tenting sutures in elective craniotomies in adults-is it necessary? A study protocol for a multicentre, investigator- and participant-blinded randomised, parallel-group, non-inferiority trial. Trials. 2021 Apr 12;22(1):273. doi: 10.1186/s13063-021-05201-z. PMID: 33845888; PMCID: PMC8042961.)).