A Comparative Analysis of Early Postoperative Outcomes of Autologous Pericranium versus High-Density Polypropylene in Cranial Duraplasty in a Tertiary Care Centre in Central India

Background and Objectives Duraplasty is commonly required when primary dural closure is not feasible during cranial surgery. Although both autologous and synthetic dural substitutes are widely used, high-quality prospective data comparing their early postoperative safety remain limited. This study aimed to compare early postoperative complication rates following cranial duraplasty using autologous pericranium versus high-density polypropylene (G-Patch). Methods This prospective comparative study included 100 consecutive patients undergoing cranial duraplasty at a tertiary care center between January and December 2021. Patients were allocated to receive either autologous pericranium (n = 50) or high-density polypropylene (G-Patch) (n = 50) using a standardized surgical technique. Patients were followed for a minimum of 30 days, and early postoperative complications—including cerebrospinal fluid leak, wound infection, and subcutaneous CSF collection—were recorded. Exploratory analyses assessed associations between postoperative complications and selected patient-related factors. Results Traumatic brain injury and intracranial space-occupying lesions were the most common indications for surgery. Most patients in both groups had an uneventful postoperative course. Early postoperative complications occurred more frequently in the synthetic graft group; however, no statistically significant difference was observed between the two graft types (p > 0.05). Wound infection was the most common complication in both cohorts. Exploratory analyses did not demonstrate significant associations between postoperative complications and patient comorbidities or substance use. Conclusion In this prospective cohort, both autologous pericranium and high-density polypropylene demonstrated acceptable short-term safety profiles for cranial duraplasty. Given the heterogeneous indications and focus on early postoperative outcomes, these findings should not be interpreted as evidence of equivalence across specific clinical scenarios. Further studies incorporating stratified analyses, longer follow-up, and functional outcomes are warranted.