gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

A comparative animal experimental study on a new collagen biomatrix versus a cadaveric dura graft for dural defects

Vergleichende tierexperimentelle Untersuchung einer neuartigen Kollagenfolie versus Leichendura zur Deckung von Duradefekten

Meeting Abstract

  • corresponding author Ulrich Knopp - Neurochirurgische Klinik, Universitätsklinikum Lübeck, Lübeck
  • E. Reusche - Institut für Neuropathologie, Universitätsklinikum Lübeck, Lübeck
  • F. Christmann - Neurochirurgische Klinik, Clemenshospital Münster, Münster
  • A. Sepehrnia - Neurochirurgische Klinik, Clemenshospital Münster, Münster

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocP 01.10

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0293.shtml

Published: April 23, 2004

© 2004 Knopp et al.
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Outline

Text

Objective

Defects of the dura mater are common during neurosurgical procedures and necessitate dural graft repair to prevent postoperative sequelae. Numerous materials have been evaluated over the past decades in the quest for the ideal dural replacement, but no product fully meets all the applicable criteria. This paper presents the results of animal studies on a collagen graft (special preparation, Baxter) for dural graft repair. The product provides a biomatrix with a special layer structure and consists of pure naturally cross-linked collagen of equine origin. Collagen preparations have been successfully used for wound cover, to stop bleeding and as a carrier for fibrin sealant. For comparison Tutoplast® Dura was used, a human cadaveric-derived dural graft preserved in a multiple stage chemical process.

Methods

Bihemispheric parietooccipital dural lesions of a defined diameter were induced in 25 sheep and subsequently closed with the collagen graft or Tutoplast® Dura, respectively. Fibrin sealant (Tisseel® / Tissucol®, Baxter) alone was used to fix the implants. Postoperative neurological abnormalities did not occur in any animal. The animals were killed at 2, 4, 8, 16 and 24 weeks. Macroscopy showed adequate dural closure at the sites of application of both products.

Results

There were no signs of graft rejection or formation of cerebrospinal fluid fistulae. The collagen graft site displayed histological signs as early as 2 weeks postoperatively consistent with a moderate Iymphocytic inflammatory response and infiltration with fibroblasts and macrophages. The graft subsequently developed a neodura-like connective tissue architecture. The Tutoplast® Dura showed onIy minimal cellular infiltration, and again the surrounding structures displayed a mild inflammatory response. The dura and neomembrane were barely distinguishable at the collagen biomatrix site 24 weeks postoperatively, but the Tutoplast® Dura displayed inadequate fusion with the dural border and was encapsulated in a connective tissue layer.

Conclusions

The outcomes demonstrate that the collagen graft can be used for dura reconstruction as temporary replacement and at the same time as a biomatrix for dura regeneration.