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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Evaluation of efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix as a dural onlay graft in a large animal model

Meeting Abstract

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  • Axel Neulen - Department of Neurosurgery, Georg August University, Göttingen, Germany
  • Jürgen Wegmann - Aesculap AG, Tuttlingen, Germany
  • Ildikó Takács - Department of Surgical Research and Techniques, University of Pécs, Hungary
  • György Wéber - Department of Surgical Research and Techniques, University of Pécs, Hungary
  • Walter Schulz-Schaeffer - Department of Neuropathology, Georg August University, Göttingen, Germany
  • Alf Giese - Department of Neurosurgery, Georg August University, Göttingen, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1826

doi: 10.3205/10dgnc297, urn:nbn:de:0183-10dgnc2970

Published: September 16, 2010

© 2010 Neulen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Among synthetic grafts for duraplasty semisynthetic collagen matrices appear promising because they have demonstrated a low risk of CSF fistulas, good tissue integration and only minor foreign body reaction. The present study was designed to investigate efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix (“BCM”, Aesculap) compared to endogenous periosteum and DuraGen (Integra NeuroSciences).

Methods: 34 pigs were randomized into 3 groups. In all animals an osteoclastic trepanation was performed, followed by excision of dura and placement of a cortical defect. After hemostasis, duraplasty was performed using either BCM, DuraGen, or periosteum. CSF tightness of the grafts and intraoperative handling were evaluated. Pigs were sacrificed after 1 and 6 months for histological analysis.

Results: BCM and DuraGen were superior in handling compared to periosteum. There was a trend for better adhesion to dura and better CSF tightness for BCM compared to DuraGen. Intraoperative CSF tightness was highest with periosteum, which was sutured into the dural defect. The time needed for duraplasty with periosteum was significantly higher (865 sec±163 sec) compared to BCM (173 sec±46 sec) or DuraGen (179 sec±30 sec). Histological analysis showed tissue integration by fibroblast ingress for all devices after 1 month. More adhesions between graft and cortex were observed with DuraGen compared to BCM and periosteum, lymphocytic reaction of the brain was comparable between the devices. After 6 months all devices were completely integrated. There was a tendency for an enhanced lymphocytic reaction of the brain parenchyma with BCM and DuraGen compared with periosteum.

Conclusions: Semisythetic collagen matrices are a promising alternative for duraplasty due to easy handling and low time consumption compared to duraplasty with periosteum. The semisynthetic bilayered collagen matrix (Aesculap) yielded similar results compared to the well established DuraGen (Integra NeuroSciences) with a tendency to less adhesions to the cortical surface and glial scar tissue.