Study and clinical application of a porcine biomembrane for the repair of dural defects

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✓ A biomembrane was developed from pig peritoneum treated with 0.65% glutaraldehyde. This was evaluated for use as a dural substitute in an animal model and in a patient population. After being treated with the glutaraldehyde solution, the biomembrane lost its antigenicity while its collagen underwent an irreversible cross-linking reaction, causing it to become a stable nonviable polymer resistant to absorption by the host. The biomembrane was used experimentally in 43 procedures on 20 dogs and was applied clinically in 614 patients. The results demonstrated that it is an acceptable material for the repair of dural defects, with the following advantages: 1) it is nontoxic to the body and brain tissues, with minimal tissue reaction; 2) its biophysical properties facilitate watertight closure with sutures; 3) its distensibility makes it suitable for decompressive surgical dural repair; and 4) its visceral surface is extremely smooth, causing virtually no adhesions with the brain tissue while the outer surface readily heals with the subcutaneous tissue.

Article Information

Address reprint requests to: Xu Bang-Zong, Department of Neurosurgery, Second Teaching Hospital of the Fourth Military College, Xi'an, Shanxi, People's Republic of China.

© AANS, except where prohibited by US copyright law.

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Figures

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    Photomicrograph showing the interface between the inner surface of a biomembrane implant and brain tissue. There are no adhesions. H & E, × 225.

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    Photomicrograph of a sample of biomembrane. The field shows mainly fibrous connective tissue. H & E, × 225.

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    Photomicrograph of the cerebral cortex of a dog with biomembrane implants showing a normal appearance. H & E, × 225.

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    Electron micrograph of the biomembrane before implantation showing collagenous and elastic fibers. × 7600.

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    Electron micrograph of the dura mater of normal dog, which consists mainly of regularly arranged collagenous fibers with a structure similar to that of the biomembrane. × 10,100.

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    Electron micrograph of the biomembrane removed after implantation showing a large amount of collagenous fiber. × 5290.

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    Left: Electron micrograph of the brain tissue of a normal dog, showing normal neurons and glia. × 4100. Right: Electron micrograph of brain tissue underneath a biomembrane implant showing mostly normal neurons and glia. × 5285.

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    Photograph at a second exploration operation in a patient 13 months after implantation of biomembrane dural substitute. No adhesion was found between the implant and brain tissue, and the cerebrum appeared normal.

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