Comparison of the efficiency, side effects and complications of the synthetic dural grafts: Beriplast and Tissudura

Abstract

The purpose of this study was to compare human fibrinogen-thrombin-based liquid dural graft; Beriplast® (Behring, Malburg, Germany) and collagen-based dural graft; Tissudura® (Baxter, Heidelberg, Germany) in terms of efficiency, side effects and complications. Thirty Spraque Dawley rats were used in this experimental study. A burrhole was opened on the left parietal bone of each subject and experimental dural defect was created. While 10 subjects were in sham group without any dural defect repair, dural defect was repaired by Beriplast in 10 subjects, by Tissudura in 10 subjects. After twenty-one day follow-up, edema, gliosis and inflammatory cell infiltration in the parenchyma, foreign body reaction in the bone, fibrosis in the epidural space and dura were evaluated histopathologically. Beriplast caused much more severe inflammation on cortex. When we compared Tissudura group with the sham group in terms of parenchymal edema and gliosis, the difference was not significant. On the other hand, we have found a significant increase in cortical parenchymal edema in Beriplast group. The last generation dural grafts result in different degrees of the tissue reaction. Severe inflammatory reaction can provide more satisfactory results in terms of watertight dural closure but on the other hand, the same reaction can be a disadvantage to the surrounding tissue.

Keywords

• Beriplast
• Dural defect
• Dural graft
• Tissudura

References

1. Alleyene, H., Cawley, C., Barrow, L., Poff, C., Powell, D., Amarpreet, B.,1998. Efficacy and biocompatibility of a photopolymerized, synthetic, absorbable hydrogel as a dural selant in a canine Craniotomy model. J. Neurosurg. 88, 308-313.
2. Ayhan, S., Tugay, C., Ortak, T., Prayson, R., Parker, M., Siemionow, M., Papay, F.A., 2002. Effect of bioabsorbable osseous fixation materials on Dura Mater and brain tissue. Plastic Reconstr. Surg. 109, 1333-1338.
3. Bhatia, S., Bergethon, R., Kemper, T., Rosiello, A., Zimbardi, P., Franzblau, C., Spatz, E.L., 1995. A synthetic dural prothesis constructed from hydroxyethylmethacrylate hydrogels. J. Neurosurg. 83, 897-902.
4. Cappabianca, P., Esposito, F., Cavallo, M., Messina, A., Solari, D., Somma, M., de Divitiis, E., 2006. Use of equine collagen foil as dura mater substitute in endoscopic endonasal transsphenoidal surgery. Surg. Neurol. 65, 144-149.
5. Chappell, E., Pare, L., Salehpour, M., Mathews, M., Middlehof, C., 2009. GORE PRECLUDE® MVP® dura substitute applied as a nonwatertight ‘underlay’ graft for craniotomies: product and technique evaluation. Surg. Neurol. 71, 126-129.
6. Dietemann, J., Bernardo, R., Bogorin, A., Eid, M., Koob, M., Nogueira, T., Vargas, M.I., Fakhoury, W., Zöllner, G., 2005. Normal and abnormal meningeal enhancement: MRI features. J. Radiol. 86, 1659-1683.
7. Dunn, J., Goa, L., 1999. Fibrin sealant: A review of its use in surgery and endoscopy. Drugs 58, 863-886.
8. Eberhard, U., Broder, M., Witzke, G., 2006. Stability of Beriplast P fibrin sealant: storage and reconstitution. Int. J. Pharm. 313, 1-4.

9. Esposito, F., Cappabianca, P., Fusco, M., Cavallo, L., Bani, G., Biroli, F., Sparano, A., de Diviitis, O., Signorelli, A., 2008. Collagen-only biomatrix as a novel dural substitute Examination of the efficacy, safety and outcome: Clinical experience on a series of 208 patients. Clin. Neurol. Neurosurg. 110, 343-351. doi: 10.1016/j.clineuro.2007.12.016.
10. Greenberg, S. 1994. Handbook of neurosurgery. Cerebrospinal fluid fistula. Third edition.
11. Grouls, R., Korsten, E., Ackerman, E., Hellebrekers, L., Zundert, A., Breimer, D., 2000. Diffusion of n-butyl-p-aminobenzoate (BAB), lidocaine and bupivacaine through the human dura-arachnoid mater in vitro. Eur. J. Pharm. Sci. 12, 125-131.
12. Handa, J., Koyama, T., 1989. Use of fibrin glue (Beriplast P) in neurosurgical practice. Nihon Geka Hokan. 58, 231-235.
13. Hatanaka, M., 1992. Expanded DPTFE surgical membrane for dura mater substitutes. Research of New Medical Devices 1, 183-193.
14. Kelly, F., Oskouian, R., Fineman, I., 2001. Collagen sponge repair of small cerebrospinal fluid leaks obviates tissue grafts and cerebrospinal fluid diversion after pituitary surgery. Neurosurgery. 49, 885-890.
15. Knopp, U., Christmann, F., Reusche, E., Sepehrnia, A., 2005. A new collagen biomatrix of equine origin versus a cadaveric dura graft for the repair of dural defects-a comparative animal experimental study. Acta. Neurochir. 147, 877-887.
16. Lage, J., Espejo, M., Palazon, J., Hernandez, F., Puerta, P., 2006. Autologous tissues for dural grafting in childen: A report of 56 cases. Childs Nervous System. Childs. Nerv. Syst. 22, 139-144.
17. Malliti, M., Page, P., Gury, C., Chomette, E., Nataf, F., Roux, F., 2004. Comparison Of Deep Wound Infection Rates Using A Synthetic Dural Substitute (Neuro-patch) or Pericranium Graft For Dural Closure: A Clinical Review Of 1 Year. Neurosurgery. 54, 599-604.
18. Matsuoka, H., Yano, K., Katsuta, Y., Morita, M., Kounoe, S., Seo, Y., Saito, T., Tomoda, H., 1996. Advantages and safety of local treatment with MMC/Beriplast P for cancer tumors. Cancer Chemotherapy Pharmacology. 38, 508-512.
19. Mukai, T., Shirahama, N., Tominaga, B., Ohno, K., Koyama, Y., Takakuda, K., 2008. Development of watertight and bioabsorbable synthetic dural substitutes. Artif. Organs. 32, 473-483. doi: 10.1111/j.1525-1594.2008.00567.x.
20. Narotam, P., Van Dellen, J., Bhoola, K., Raidoo, D., 1993. Experimental evaluation of collagen sponge as a dural graft. Br. J. Neurosurg. 7, 635-641.
21. Narotam, P., Van Dellen, J., Bhoola, K., 1995. A Clinicopathological study of collagen sponge as a dural greft in neurosurgery. J. Neurosurg. 82, 406-412.
22. Narotam, P.K., Jose, S., Nathoo, N., Taylon, C., Vora, Y., 2004. Collagen Matrix (DuraGen) in Dural Repair: Analysis of a New Modified Technique. Spine. Newyork: Lippincott Williams & Wilkins. 15, 2861-2867.
23. Narotam, K., Qiao, F., Nathoo, N., 2009. Collagen matrix duraplasty for posterior fossa surgery: evaluation of surgical technique in 52 adult patients. J. Neurosurg. 111, 380-386. 10.3171/2008.10.JNS08993.
24. Nistor, F., Chiari, M., Maier, H., Hehl, K., 1997. The fixed combination of collagen with components of fibrin adhesive-a new hemostyptic agent in skull base procedures. Skull Base Surg. Thieme Medical Publishers, New York. 1, 23-30.
25. Nussbaum, E., Maurer, K., McDonald, V., 1989. Vicryl (Polyglactin 910) mesh as a dural substitute in the presence of pia arachnoid injury. J. Neurosurg. 71, 124-127.
26. San-Galli, F., Deminiere, C., Guerin, J., Rabaud, M., 1996. Use of a biodegradable elastin-fibrin material, Neuroplast, as a dural substitute. Biomaterials. 17, 1081-1085.
27. Schelling, G., Block, T., Gökel, M., 1998. Application of fibrinogen-trombincollagen-based hemostatic agent in experimental injuries of liver and spleen. J. Trauma. 28, 472-475.
28. Sekhar, N., Sarma, S., Morita, A., 2001. Dural Reconstruction with Fascia, Titanium Mesh, and Bone Screws: Technical Note. Neurosurgery. 49, 749-752.
29. Shimada, Y., Hongo, M., Miyakoshi, N., Sugawara, T., Kasukawa, Y., Ando, S., 2006. Dural substitute with polyglycolic acid mesh and fibrin glue for dural repair: Technical note and preliminary results. J. Orthop. Sci. 11, 454-458.
30. Stendel, R., Danne, M., Fiss, I., Klein, I., Schilling, A., Hammersen, S., 2008. Efficacy and safety of a collagen matrix for cranial and spinal dural reconstruction using different fixation techniques. J. Neurosurg. 109, 215-221. doi: 10.3171/JNS/2008/109/8/0215.
31. Takçı, E., Kadıoglu, H., Bahçeci, H., Aydın, İ., 2001. Deneysel Kranial Dural Defektlerin Onarımında Dehidrate Human Dura Mater Greftlerininin Kullanımı Histopatolojik Değerlendirme. Türk Nörosirürji Dergisi. 11, 178-184.
32. Topsakal, C., Barut, S., Bilge, T., Sahin, Y., Altundal, N., Aydın, Y., 1993. Nöroşirürji’de fibrin yapıştırıcılarının kullanımı: 6 olgunun analizi. Türk Nörosirürji Dergisi. 3, 30-34.
33. Vinas, F., Ferris, D., Kupsky, W., Dujovny, M., 1999. Evaluation of expanded polytetrafluoroethylene (ePTFE) versus polydioxanone (PDS) for the repair of dura mater defects. Neurol. Res. 21, 262-268.