Comparison of two duraplasty techniques in decompressive craniectomy for traumatic brain injury: a randomized clinical study

Abstract Background Cerebrospinal fluid (CSF) leakage is a common complication following decompressive craniectomy. This study aimed to compare two duraplasty techniques (C-shaped and linear) in terms of surgical outcomes and complications in patients with traumatic brain injury (TBI). Methods In this randomized, non-blinded clinical trial, 29 patients with TBI undergoing decompressive craniectomy were allocated to either Group A (C-shaped duraplasty) or Group B (linear duraplasty). Operative time, duration of hospitalization, CSF leakage, postoperative complications, and Glasgow Outcome Scale (GOS) were evaluated. Results Group B (linear technique) showed significantly shorter duraplasty time (11.5 ± 3.7 vs. 19.5 ± 3.7 min, p = 0.046) and hospitalization duration (7.4 ± 2.0 vs. 15.0 ± 2.5 days, p = 0.038). CSF leakage occurred in 40% of Group A vs. 14.3% in Group B. GOS was significantly better in Group B both immediately post-op and one month after discharge. Conclusion The linear duraplasty technique demonstrated superior outcomes in terms of operative time, CSF leakage, and functional recovery, suggesting it may be preferable in decompressive craniectomy for TBI.