Purpose: AlloDerm® (LifeCell Corporation, Branchburg, NJ) is an acellular human cadaveric dermal matrix. The structural extracellular framework is retained, supporting revascularization and remodeling into the native tissue with minimal risk of infection, extrusion, or rejection. Coverage of wounds with exposed central nervous system structures frequently requires pedicled or free muscle transfers. However, when these options are limited, AlloDerm may serve as an alternative means of wound coverage.

Methods: Patients were chosen for this technique when more traditional methods were unsuccessful. Two patients with myelomeningocele had persistent cerebrospinal fluid (CSF) leaks despite muscle coverage. One patient with craniosynostosis had a dural defect after repair. One patient had a large area of exposed brain after flap coverage became non-viable.

Results: Four patients (age 3-76 ) were evaluated. Healing was complete without further CSF leak in three patients. In one, the AlloDerm served as a temporary treatment prior to flap coverage.

Conclusions: Using an acellular dermal matrix is well-tolerated and provides durable coverage with minimal infectious risk to the central nervous system. Further experience with this product will help determine its overall applicability to treat CSF leaks and exposed central nervous system structures.