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

Axel Neulen, Angelika Gutenberg, Ildikó Takács, G. Wéber, Jürgen Wegmann, Walter Schulz-Schaeffer, Alf Giese

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Semisynthetic collagen matrices are promising duraplasty grafts with low risk of cerebrospinal fluid (CSF) fistulas, good tissue integration and minor foreign body reaction. The present study investigates the efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix (BCM, B. Braun Aesculap) as dural onlay graft for duraplasty. Methods: Thirty-four pigs underwent osteoclastic trepanation, excision of the dura, and placement of a cortical defect, followed by duraplasty using BCM, Suturable DuraGen™ (Integra Neuroscience), or periosteum. CSF tightness and intraoperative handling of the grafts were evaluated. Pigs were sacrificed after 1 and 6 months for histological analysis. Findings: BCM and DuraGen™ showed superior handling than periosteum with a trend for better adhesion to dura and CSF tightness for BCM. Periosteum, which was sutured unlike the synthetic grafts, had the highest intraoperative CSF tightness. Duraplasty time with periosteum was significantly higher (14.4±2.7 min) compared with BCM (2.8±0.8 min) or DuraGen™ (3.0±0.5 min). Tissue integration by fibroblast infiltration was observed after 1 month for all devices. More adhesions between graft and cortex were observed with DuraGen™ compared with BCM and periosteum. No relevant adhesions between leptomeninges and BCM were observed and all devices showed comparable lymphocytic reaction of the brain. All devices were completely integrated after 6 months. BCM and DuraGen™ showed a trend for an enhanced lymphocytic reaction of the brain parenchyma compared with periosteum. Implant rejection was not observed. Conclusion: Semisythetic collagen matrices are an attractive alternative in duraplasty due to their easy handling, lower surgical time, and high biocompatibility.

Original languageEnglish
Pages (from-to)2241-2250
Number of pages10
JournalActa Neurochirurgica
Volume153
Issue number11
DOIs
Publication statusPublished - Nov 2011

Fingerprint

Inlays
Periosteum
Collagen
Animal Models
Transplants
Cerebrospinal Fluid
Equipment and Supplies
Swine
Trephining
Foreign-Body Reaction
Brain
Operative Time
Neurosciences
Fistula
Fibroblasts

Keywords

  • BCM
  • Cerebrospinal fluid leak
  • Collagen matrix
  • DuraGen
  • Dural defect repair
  • Dural substitute
  • Duraplasty

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Evaluation of efficacy and biocompatibility of a novel semisynthetic collagen matrix as a dural onlay graft in a large animal model. / Neulen, Axel; Gutenberg, Angelika; Takács, Ildikó; Wéber, G.; Wegmann, Jürgen; Schulz-Schaeffer, Walter; Giese, Alf.

In: Acta Neurochirurgica, Vol. 153, No. 11, 11.2011, p. 2241-2250.

Research output: Contribution to journalArticle

Neulen, Axel ; Gutenberg, Angelika ; Takács, Ildikó ; Wéber, G. ; Wegmann, Jürgen ; Schulz-Schaeffer, Walter ; Giese, Alf. / Evaluation of efficacy and biocompatibility of a novel semisynthetic collagen matrix as a dural onlay graft in a large animal model. In: Acta Neurochirurgica. 2011 ; Vol. 153, No. 11. pp. 2241-2250.
@article{e1697001e5ff4f038b7051ee4634cf41,
title = "Evaluation of efficacy and biocompatibility of a novel semisynthetic collagen matrix as a dural onlay graft in a large animal model",
abstract = "Background: Semisynthetic collagen matrices are promising duraplasty grafts with low risk of cerebrospinal fluid (CSF) fistulas, good tissue integration and minor foreign body reaction. The present study investigates the efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix (BCM, B. Braun Aesculap) as dural onlay graft for duraplasty. Methods: Thirty-four pigs underwent osteoclastic trepanation, excision of the dura, and placement of a cortical defect, followed by duraplasty using BCM, Suturable DuraGen™ (Integra Neuroscience), or periosteum. CSF tightness and intraoperative handling of the grafts were evaluated. Pigs were sacrificed after 1 and 6 months for histological analysis. Findings: BCM and DuraGen™ showed superior handling than periosteum with a trend for better adhesion to dura and CSF tightness for BCM. Periosteum, which was sutured unlike the synthetic grafts, had the highest intraoperative CSF tightness. Duraplasty time with periosteum was significantly higher (14.4±2.7 min) compared with BCM (2.8±0.8 min) or DuraGen™ (3.0±0.5 min). Tissue integration by fibroblast infiltration was observed after 1 month for all devices. More adhesions between graft and cortex were observed with DuraGen™ compared with BCM and periosteum. No relevant adhesions between leptomeninges and BCM were observed and all devices showed comparable lymphocytic reaction of the brain. All devices were completely integrated after 6 months. BCM and DuraGen™ showed a trend for an enhanced lymphocytic reaction of the brain parenchyma compared with periosteum. Implant rejection was not observed. Conclusion: Semisythetic collagen matrices are an attractive alternative in duraplasty due to their easy handling, lower surgical time, and high biocompatibility.",
keywords = "BCM, Cerebrospinal fluid leak, Collagen matrix, DuraGen, Dural defect repair, Dural substitute, Duraplasty",
author = "Axel Neulen and Angelika Gutenberg and Ildik{\'o} Tak{\'a}cs and G. W{\'e}ber and J{\"u}rgen Wegmann and Walter Schulz-Schaeffer and Alf Giese",
year = "2011",
month = "11",
doi = "10.1007/s00701-011-1059-5",
language = "English",
volume = "153",
pages = "2241--2250",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "11",

}

TY - JOUR

T1 - Evaluation of efficacy and biocompatibility of a novel semisynthetic collagen matrix as a dural onlay graft in a large animal model

AU - Neulen, Axel

AU - Gutenberg, Angelika

AU - Takács, Ildikó

AU - Wéber, G.

AU - Wegmann, Jürgen

AU - Schulz-Schaeffer, Walter

AU - Giese, Alf

PY - 2011/11

Y1 - 2011/11

N2 - Background: Semisynthetic collagen matrices are promising duraplasty grafts with low risk of cerebrospinal fluid (CSF) fistulas, good tissue integration and minor foreign body reaction. The present study investigates the efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix (BCM, B. Braun Aesculap) as dural onlay graft for duraplasty. Methods: Thirty-four pigs underwent osteoclastic trepanation, excision of the dura, and placement of a cortical defect, followed by duraplasty using BCM, Suturable DuraGen™ (Integra Neuroscience), or periosteum. CSF tightness and intraoperative handling of the grafts were evaluated. Pigs were sacrificed after 1 and 6 months for histological analysis. Findings: BCM and DuraGen™ showed superior handling than periosteum with a trend for better adhesion to dura and CSF tightness for BCM. Periosteum, which was sutured unlike the synthetic grafts, had the highest intraoperative CSF tightness. Duraplasty time with periosteum was significantly higher (14.4±2.7 min) compared with BCM (2.8±0.8 min) or DuraGen™ (3.0±0.5 min). Tissue integration by fibroblast infiltration was observed after 1 month for all devices. More adhesions between graft and cortex were observed with DuraGen™ compared with BCM and periosteum. No relevant adhesions between leptomeninges and BCM were observed and all devices showed comparable lymphocytic reaction of the brain. All devices were completely integrated after 6 months. BCM and DuraGen™ showed a trend for an enhanced lymphocytic reaction of the brain parenchyma compared with periosteum. Implant rejection was not observed. Conclusion: Semisythetic collagen matrices are an attractive alternative in duraplasty due to their easy handling, lower surgical time, and high biocompatibility.

AB - Background: Semisynthetic collagen matrices are promising duraplasty grafts with low risk of cerebrospinal fluid (CSF) fistulas, good tissue integration and minor foreign body reaction. The present study investigates the efficacy and biocompatibility of a novel semisynthetic bilayered collagen matrix (BCM, B. Braun Aesculap) as dural onlay graft for duraplasty. Methods: Thirty-four pigs underwent osteoclastic trepanation, excision of the dura, and placement of a cortical defect, followed by duraplasty using BCM, Suturable DuraGen™ (Integra Neuroscience), or periosteum. CSF tightness and intraoperative handling of the grafts were evaluated. Pigs were sacrificed after 1 and 6 months for histological analysis. Findings: BCM and DuraGen™ showed superior handling than periosteum with a trend for better adhesion to dura and CSF tightness for BCM. Periosteum, which was sutured unlike the synthetic grafts, had the highest intraoperative CSF tightness. Duraplasty time with periosteum was significantly higher (14.4±2.7 min) compared with BCM (2.8±0.8 min) or DuraGen™ (3.0±0.5 min). Tissue integration by fibroblast infiltration was observed after 1 month for all devices. More adhesions between graft and cortex were observed with DuraGen™ compared with BCM and periosteum. No relevant adhesions between leptomeninges and BCM were observed and all devices showed comparable lymphocytic reaction of the brain. All devices were completely integrated after 6 months. BCM and DuraGen™ showed a trend for an enhanced lymphocytic reaction of the brain parenchyma compared with periosteum. Implant rejection was not observed. Conclusion: Semisythetic collagen matrices are an attractive alternative in duraplasty due to their easy handling, lower surgical time, and high biocompatibility.

KW - BCM

KW - Cerebrospinal fluid leak

KW - Collagen matrix

KW - DuraGen

KW - Dural defect repair

KW - Dural substitute

KW - Duraplasty

UR - http://www.scopus.com/inward/record.url?scp=83055194648&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=83055194648&partnerID=8YFLogxK

U2 - 10.1007/s00701-011-1059-5

DO - 10.1007/s00701-011-1059-5

M3 - Article

C2 - 21739175

AN - SCOPUS:83055194648

VL - 153

SP - 2241

EP - 2250

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 11

ER -