DUROPLASTY: REVIEW OF MATERIALS AND TECHNIQUES

Abstract

In most cases, a dura mater defect is the result of a traumatic brain injury. Traumatic brain injury is an important issue, both medically and socio-economically, as it is accompanied by significant mortality and disability of patients of working age. Cerebrospinal fluid leakage is one of the most common causes of death in neurosurgical patients. Complications due to depressurization of dura mater and failure to close the defects of the membrane can be: cerebrospinal fluid leakage and cerebrospinal fluid fistula, infections and other complications that can lead to a longer period of hospitalization and treatment costs. Therefore, elimination of the dura mater defect is the most important element of surgical treatment and prevention of many intracranial complications, via preventive medical rehabilitation of neurosurgical patients. Despite the significant historical experience and practice of neurosurgical clinics, the issue of reliable sealing of defects of the dura mater defect still remains relevant. Over the past decades, various auto-, allo-, xenografts, and synthetic materials have been tested. Vitro studies investigated into the properties and compared the morphological characteristics of autografts: dura mater, supracranial aponeurosis and temporal fascia, xenografts: materials based on decellularized bovine and porcine pericardium, biomichannel differences between human dura mater, stretched polytetrafluoroethylene and materials made of bovine skin collagen and bovine pericardium. With the constant progress of chemical technologies, new substitutes for dura mater will be created, and they will be closer in structure to normal dura mater, such that will cause minimal inflammatory reactions or their absence, easy to use and biodegradable. Thus, the development and comprehensive research, including in-vitro and in-vivo experiments, as well as research on model animals, are an urgent issue of medical and biological nature, which aims to solve the problem of closing defects of dura mater without short-term and long-term postoperative complications and improve the quality of life of patients.

Keywords

• dura mater, duroplasty, autodrafts, allografts, xenografts, dural substitute