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Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery

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Summary

Surgical experience with 2959 allogeneic and xenogeneic dense connective tissue grafts (1767 of fascia lata, 909 of pericardium, and 283 of dura mater), used in 2665 neurosurgical operations performed in the course of 20 years (1976 to 1995) is reported.

Duraplasty using either allogeneic or xenogeneic grafts has had a similar, and favourable clinical outcome. Nevertheless, the pliable deep frozen fascia lata grafts, which could be used in any location, have been reserved for sella turcica plugging, anterior cranial base plasty, aneurysmal wrapping, and surgery of lipomyelomeningocele. Pericardium and dura mater grafts were in the majority of cases used over the brain convexity and posterior cranial fossa. Ovine pericardium proved to be superior to bovine and allogeneic pericardia because of its workability, flexibility, reduced thickness, and better transparency.

Postsurgical complications occurred in 7.3%, and they were: 1) cerebrospinal fluid fistulas in 2.8%; 2) meningites in 2.3% (aseptic 1.4%, bacterial 0.8%, and tumoural 0.1% meningites); 3) pseudomeningoceles in 2.2%; 4) wound infections in 0.6%; 5) malresorptive hydrocephalus in 0.5%; and 6) adhesions to nerve tissue in 0.5%. The majority of complications healed without surgery. Forty-eight grafts (1.6%) failed to fulfil the requirements of the surgeon, and 46 of them were re-operated upon. Though another thirty-nine grafts healed successfully, 39 shunts (1.5%) had to be performed for malresorptive hydrocephalus (0.9%), and/or for a big pseudomeningocele (0.6%). So, the pure complication rate in 2665 duraplasties was 3.1%.

The complex evaluation of the allogeneic and xenogeneic grafts (fascia, pericardium, and dura mater), used for duraplasty in neuro-surgery during the last 20 years proved them, as remarkably good, with a success rates of 96.9%.

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References

  1. Allyene CH Jr., Barrow DL (1994) Immune response in hosts with cadaveric durai grafts. Report of two cases. J Neurosurg 81: 610–613

    PubMed  Google Scholar 

  2. Anson JA, Marchand EP (1996) Bovine pericardium for dural grafts: Clinical results in 35 patients. Neurosurgery 39: 764–768

    PubMed  Google Scholar 

  3. Awwad EE, Smith KR, Martin DS,et al (1991) Unusual hemorrhage with use of synthetic durai subsitute: MR findings. J Comput Assist Tomogr 15: 618–620

    PubMed  Google Scholar 

  4. Cantore G, Guidetti B, Delfini R (1987) Neurosurgical use of human dura mater sterilized by gamma rays and stored in aicohol: long-term results. J Neurosurg 66: 93–95

    PubMed  Google Scholar 

  5. Chvapil M, Suwelack W, Eckmayer Z (1985) Medical use of collagen sponges reconstituted by freeze-drying. In: Commission C1 (eds) Fundamentals and applications of freeze-drying to biological materials, drugs and foodstuffs. International Institute of Refrigeration Commission, Tokyo, pp 73–78

    Google Scholar 

  6. Ernestus RI, Ketter G, Klug N (1995) Duraersatz bei intrakraniellen Operationen. Zentralbl Neurochir 56: 106–110

    PubMed  Google Scholar 

  7. Fisher WS III, Braun D (1992) Closure of posterior fossa dural defects using a dural substitute: Technical note. Neurosurgery 31: 155–156

    PubMed  Google Scholar 

  8. Klen R (1959) Cold shock. Folia Biol 1: 82–83

    Google Scholar 

  9. Klen R (1979) A comparison of methods of tissue graft decontamination: review. Sbor Věd Prací LF UK Hradec Králové 22 [Suppl] 1: 63–70

    Google Scholar 

  10. Klen R (1982) Biological principles of tissue banking. Pergamon, Oxford

    Google Scholar 

  11. Klen R, Metelka M, Pařizek J (1977) Freeze-dried-homogenous grafts of fascia lata in neurosurgery. J Neurosurg Sci 21: 247–250

    Google Scholar 

  12. Kroó M (1963) Dural plastics. Sbor Věd Prací LF UK Hradec Králové 6 [Suppl] 1: 343–347 (Czech)

    Google Scholar 

  13. Kroó M, Klen R (1960) Our experience with frozen fascial and dural grafts used for duraplasty. Lék Zpr LF UK Hradec Králové 5: 80–85 (Czech)

    Google Scholar 

  14. Kroó M, Pařizek J (1978) Complications in transplantation of fascial grafts in neurosurgery. Sbor Věd Praci LF UK Hradec Králové 21: 443–447

    Google Scholar 

  15. Krstić RV (1985) General histology of the mammal. An atlas for Students of medicine and biology. Springer, Berlin Heidelberg New York Tokyo

    Google Scholar 

  16. Lanzieri CF, Larkins M, Mancall A,et al (1988) Cranial postoperative site: MR imaging appearance. AJNR 9: 27–34

    PubMed  Google Scholar 

  17. Laun A, Tonn JC, Jerusalem C (1990) Comparative study of lyophilized human dura mater and lyophilized bovine pericardium as dural substitutes in neurosurgery. Acta Neurochir (Wien) 107: 16–21

    Google Scholar 

  18. Měřička P (1991) Preservation and clinical application of soft tissue grafts. Charité Report 7: 8

    Google Scholar 

  19. Měřička P (1991) A specially pretreated freeze-dried dura mater — a perspective material for duraplasty. Lék Zpr LF UK Hradec Králové 36: 49–59 (Czech)

    Google Scholar 

  20. Měřička P, Hušek Z, Straková H,et al (1986) Vorbereitung und klinische Anwendung von xenogenen, durch Glutaraldehyd fixierten, lyophilisierten Pericardium-Transplantaten. Probl Hämatol Transf Transpl 7: 345–355

    Google Scholar 

  21. Narotam PK, van Dellen JR, Bhoola KD (1995) A clinicopathological study of collagen sponge as a durai graft in neurosurgery. J Neurosurg 82: 406–412

    PubMed  Google Scholar 

  22. Nussbaum CE, Maurer PK, McDonald JV (1989) Vicryl (polyglactin 910) mesh as a dural substitute in the presence of pia arachnoid injury. J Neurosurg 71: 124–127

    PubMed  Google Scholar 

  23. O'Neil P, Booth A (1984) Use of porcine dermis as a dural subsitute in 72 patients. J Neurosurg 61: 351–354

    PubMed  Google Scholar 

  24. Pařizek J (1978) Fascial grafts in pediatric neurosurgery. Sbor Věd Prací LF UK Hradec Králové 21: 437–441

    Google Scholar 

  25. Pařízek J, Hušek Z, Měřička P,et al (1996) Ovine pericardium: a new material for duraplasty. J Neurosurg 84: 508–513

    PubMed  Google Scholar 

  26. Pařízek J, Měřička P (1990) Duraplasty with pretreated freezedried sterilized human dura mater. Sbor Věd Prací LF UK Hradec Královè 33: 135–143

    Google Scholar 

  27. Pařízek J, Měřička P, Němeček S,et al (1996) Allogeneic cartilage used for skull base plasty in children with primary intra-nasal encephalomeningocele associated with cerebrospinal fluid rhinorrhea. Childs Nerv Syst 12: 136–141

    PubMed  Google Scholar 

  28. Pařízek J, Měřička P, Špaček J,et al (1987) Plastic operations of the dura mater. Physical properties of some materials in experiments. Čs Neurol Neurochir 50: 73–82 (Czech)

    Google Scholar 

  29. Pařízek J, Měřička P, Špaček J,et al (1987) The importance of duraplasty and securing liquor circulation after operations on posterior cranial fossa in children. Čs Neurol Neurochir 50: 370–379 (Czech)

    Google Scholar 

  30. Pařízek J, Měřička P, Špaček J,et al (1989) Xenogeneic pericardium as a dural subsitute in reconstruction of suboccipital dura mater in children. J Neurosurg 70: 905–909

    PubMed  Google Scholar 

  31. Pařízek J, Šercl M, Michl A,et al (1994) Posterior fossa duraplasty in children: remarks on surgery and clinical and CT follow-up. Childs Nerv Syst 10: 444–449

    PubMed  Google Scholar 

  32. Petr R (1966) Surgical close of the liquorrheal fistula of iatrogenic origin in the area of the sella turcica. Rozhl Chir 45: 731–734 (Czech)

    PubMed  Google Scholar 

  33. Probst Ch (1990) Neurosurgical treatment of traumatic frontobasal CSF fistulas in 300 patients (1967–1989). Acta Neurochir (Wien) 106: 37–47

    Google Scholar 

  34. Straková H, Měřička P (1991) Analysis of the demand of tissue grafts used for duraplasties in the Czech and Slovak Federal Republic. Lék Zpr LF UK Hradec Králové 36: 177–186 (Czech)

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Medical Faculty of Charles University, Hradec Králové, Czech Republic

    J. Pařízek, P. Šuba & J. Němečková

  2. Tissue Bank, Medical Faculty of Charles University, Hradec Králové, Czech Republic

    P. Měřička & Z. Hušek

  3. Department of Pathology, Medical Faculty of Charles University, Hradec Králové, Czech Republic

    J. Špaček

  4. Department of Histology and Embryology, Medical Faculty of Charles University, Hradec Králové, Czech Republic

    S. Němeček

  5. Department of Radiology, Medical Faculty of Charles University, Hradec Králové, Czech Republic

    M. Šercl & P. Eliáš

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  1. J. Pařízek
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Pařízek, J., Měřička, P., Hušek, Z. et al. Detailed evaluation of 2959 allogeneic and xenogeneic dense connective tissue grafts (fascia lata, pericardium, and dura mater) used in the course of 20 years for duraplasty in neurosurgery. Acta neurochir 139, 827–838 (1997). https://doi.org/10.1007/BF01411400

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