Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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29-APRIL-2009 AHMAD RIYAD
AL-HEAT 24 YEARS WOUND DEHISCENCE AFTER EXPLORATION OF
THE CAUDA EQUINA 10 DAYS AFTER WITH CSF LEAK.
The patient was operated by
me 10 days ago
for gun soot shrapnels in the cauda equina. The
patient start to show some improvement of the
left lower limb, but wound dehiscence took place
and CSF leak started to escalate.
The wound was opened and the
Tachyseal completely disappeared and the
surgicel was in the lower corner of the wound.
The CSF was coming from the left side from where
the previous big shrapnel was removed, which was
locating extra and intradural. There is no
dura to repair. The bony defect was extended
slightly up and the looking healthy dura was
opened and external drain was inserted about 10
cm above the wound and the xanthochromic CSF
came through it. It was directed to the right
side 20 cm away from the midline. To avoid using
artificial elements, the paraspinal muscles were
dissected, so that a layer was created to cover
the scarrous running rootlets. The meticulous
water-tight closure of the wound was achieved.
The back slap of the right
lower limb was changed.
Smooth postoperative recovery
with the external drain attached to its external
part for draining and daily delivery of
gentamicine, papaverine and
This case showing the
disappearance of Tachyseal and its useless role
and the reaction to foreign bodies such as these
artificial materials. Using his own paraspinal
muscles, reflected as flap is the only option
remaining in this case.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .