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Study finds new sealant gel effective in closing spinal wounds postoperatively

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A national multicenter randomized study by researchers with the University of California – Davis Health System has found a polyethylene glycol hydrogel sealant to be effective in the postoperative sealing of spinal wounds, according to a press release.

The gel plugs miniscule leaks in the dura of the spinal cord. Researchers note, however, it does not take the place of suture work.

“This substance is synthetic so there is no possibility of disease transmission, but does not replace a careful surgical technique of closing the dura with the sutures,” lead author Kee D. Kim, MD, stated in the release. “This sealant allows easy repair of spinal leak that may be present even after best attempts at dural closure with suturing.”

Kim’s team worked with a cohort of 158 patients who were treated at 24 centers and randomized with a ratio of 2:1 for sealant patients vs. control patients. One hundred and two patients received the sealant, with 56 receiving standard care. Working with a primary endpoint of intraoperative watertight closure, the group used secondary endpoints of postoperative cerebrospinal fluid evaluation, infection and wound healing.

The watertight nature of the seals was determined through use of the Valsalva maneuver, with researchers essentially trying to expel the spinal fluid through the closed dura, according to the release. Overall the study found patients treated with the gel demonstrated a significantly higher rate of watertight closure than the control group — 100% vs. 64.3%, respectively.

The gel’s sealing rate as well as its inability to transmit disease or cause infection make it a viable option for the purpose of sealing the dura after spinal surgery, the authors concluded.

Reference:

• Kim KD, Wright NM. Polyethylene glycol (PEG) hyrdrogel spinal sealant (DuraSeal Spinal Sealant) as an adjunct to sutured dural repair in the spine: Results of a prospective, multicenter, randomized controlled study. Spine. 2011. doi: 10.1097/BRS.0b013e3181fdb4db
• www.ucdmc.ucdavis.edu

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