• Umit Eroglu, Murat Zaimoğlu, Emre Yağız Sayacı, Hasan Caglar Ugur, Ayhan Attar, Gokmen Kahilogullari, Melih Bozkurt, Mustafa Ağahan Ünlü, Onur Özgüral, İhsan Doğan, Kutsal Devrim Seçinti, Bilal Abbasoğlu, Koral Erdoğan, Elif Gökalp, Fatih Yakar, Yusuf Şükrü Çağlar, and Aaron Cohen-Gadol.
• Faculty of Medicine, Department of Neurosurgery, Ankara University, Ankara, Turkey.
• World Neurosurg. 2021 Sep 1; 153: e403-e407.

ObjectiveIn this study, we investigated if and when dural tenting sutures are necessary during craniotomy.MethodsResults from 437 patients 18-91 years of age (average, 43.5 years) who underwent supratentorial craniotomy between 2014 and 2019 were evaluated. The patients were categorized into 1 of 3 groups: patients who had at least 3 prophylactic dural tenting sutures placed before opening of the dura (group 1); patients who had at least 3 dural tenting sutures placed after surgery was completed, during closure (group 2); or patients who had no dural tenting sutures (group 3 [control]). All such sutures in groups 1 and 2 were placed in the circumference of the craniotomy and dural junction. No central dural tenting sutures were placed in any of the patients.ResultsAmong the 437 patients, 344 underwent surgery for the first time and 93 were undergoing a second surgery. Cranial computed tomography imaging was performed for each patient 1 hour, 3 days, and 1 month after surgery. In group 1, 3 patients had a cerebral cortex contusion and 2 patients had acute subdural hematoma after the sutures were placed. In groups 2 and 3, none of the patients had a cerebral cortex contusion or acute subdural hematoma. Fewer complications were observed when dural tenting sutures were placed during postsurgical closure.ConclusionsPlacing dural tenting sutures is an important technique for ensuring hemostasis. However, when not needed, they seem to cause inadvertent complications. As our results suggest, knowing when and where to use them is equally important.Copyright © 2021 Elsevier Inc. All rights reserved.

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