Article Text

Download PDFPDF

Necessity of dural tenting sutures in modern neurosurgery: protocol for a systematic review
  1. Łukasz Przepiórka1,
  2. Przemysław Kunert1,
  3. Jarosław Żyłkowski2,
  4. Jan Fortuniak3,
  5. Patrycja Larysz4,
  6. Dariusz Szczepanek5,
  7. Karol Wiśniewski3,
  8. Dariusz Jaskólski3,
  9. Piotr Ładziński4,
  10. Radosław Rola5,
  11. Tomasz Trojanowski5,
  12. Andrzej Marchel1
  1. 1 Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
  2. 2 Second Department of Radiology, Medical University of Warsaw, Warsaw, Poland
  3. 3 Department of Neurosurgery and Oncology of Central Nervous System, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
  4. 4 Department of Neurosurgery, Medical University of Silesia, Regional Hospital, Sosnowiec, Poland
  5. 5 Neurosurgery and Pediatric Neurosurgery Department in Lublin, Medical University of Lublin, Lublin, Poland
  1. Correspondence to Dr Przemysław Kunert; przemyslaw.kunert{at}


Introduction The ongoing need for dural tenting sutures in a contemporary neurosurgical practice has been questioned in the literature for over two decades. In the past, these sutures were supposed to prevent blood collecting in the potential space between the skull and the dura by elevating the latter. Theoretically, with modern haemostasis and proper postoperative care, this technique should not be necessary and the surgery time can be shortened. Unfortunately, there is no evidence-based proof to either support or reject this hypothesis.

Methods and analysis The systematic review will be performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and The Cochrane Handbook for Systematic Reviews of Interventions. Eight electronic databases of peer-reviewed journals will be searched, as well as other sources. Eligible articles will be assessed against inclusion criteria. The intervention is not tenting the dura and this will be compared with the usual dural tenting sutures. Where possible, ‘summary of findings’ tables will be generated.

Ethics and dissemination Ethical committee approval is not required for a systematic review protocol. Findings will be presented at international neurosurgical conferences and published in a peer-reviewed medical journal.

PROSPERO registration number CRD42018097089.

  • craniotomy
  • extradural hematoma
  • dural tenting sutures

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Patient consent for publication Not required.

  • Contributors ŁP guarantor of the review. ŁP conceived the presented idea and prepared the manuscript; PK critically revised the manuscript, AM validated the final version of the manuscript; JŻ analyzed the data; DJ, JF, and KW contributed to the design of the study; PŁ and PL helped supervise the project; RR, DS, and TT provided the methodologic background. All authors reviewed the final manuscript.

  • Funding Supported with research funds from the Department of Neurosurgery, Medical University of Warsaw (1M5/N/18).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Author note In the event of protocol amendments, the date of each amendment will be accompanied by a description of the change and the rationale.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.