Equine pericardium for dural grafts: clinical results in 200 patients.
Abstract: Serous sheets are currently used in Neurosurgery as dural substitute. The aim of this study is to demonstrate that the horse pericardium, which has the essential charasteristics of reabsorbable membranes and moreover is BSE-free, is an excellent dural substitute. Methods: 200 patients, 53 suffering from cranial traumatic conditions and 97 from cranial and craniospinal neoplastic pathologies, underwent a surgical procedure with the application of horse pericardium as a dural prosthesis. Results: The follow-up controls of the patients included a neurosurgical visit and advanced diagnostic imaging (CT or MR). In the first 3 cases, an accumulation of CSF occurred under the surgical edge. Lumbar 7-days drainage was required in just one case. The use of Zero 5 suture seems to have obviated this problem, as it was never observed again in subsequent cases. The diagnostic imaging showed no alterated images and no clinical-neurological sequelae regarding the prosthesis in question were recorded. Conclusions: The Audiomesh Neuro prosthesis has all the characteristics of reabsorbable membranes: they are free from antigenic effects and do not produce any toxic catabolites. The membrane proved to be resistant to surgical suture, impermeable to CSF and is transparent. Yet the suture must be carried out carefully through a small non-traumatic needle. Audiomesh Neuro does not adhere to the underlying cerebral cortex and does not cause any clinical evidence or radiological artifacts.
Publication Date: 2007-03-21 PubMed ID: 17369787
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- Clinical Trial
- Journal Article
Summary
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This research paper discusses the testing and effectiveness of using equine pericardium as a dural graft substitute in neurosurgery. Trials conducted on 200 patients demonstrated promising results, with minor complications managed through changes in surgical techniques.
Objective of the Research
- The aim of this study was to explore the effectiveness of using horse pericardium, which possesses essential qualities of reabsorbable membranes and is BSE-free, as a dural graft substitute in neurosurgery.
- This approach was tested on 200 patients, where horse pericardium was applied as a dural prosthesis.
Methodology
- The researchers recruited 200 patients for the study, 53 of whom were suffering from cranial traumatic conditions, and the remaining 97 from cranial and craniospinal neoplastic pathologies.
- On these patients, a surgical procedure was performed with the application of a horse pericardium dural prosthesis.
- Post-surgery recovery was tracked closely in all patients through neurosurgical visits and advanced diagnostic imaging (CT or MR).
Results
- In the initial three cases, an accumulation of cerebral spinal fluid (CSF) took place under the surgical edge. In one case, a 7-day lumbar drainage was required.
- After the introduction of the Zero 5 suture, researchers did not observe this problem in subsequent cases.
- No altered images were observed in the diagnostic imaging, and no clinical-neurological sequelae concerning the prosthesis were recorded.
Conclusion
- The Audiomesh Neuro prosthesis, made from horse pericardium, fulfilled the criteria of reabsorbable membranes and did not display any antigenic effects or produce toxic catabolites.
- The membrane was found to be resistant to surgical suture, impermeable to CSF, and transparent. However, suturing must be done carefully with a non-traumatic needle.
- The Audiomesh Neuro did not adhere to the cerebral cortex underneath it and did not cause any discernible clinical implications or generate radiological artifacts.
Cite This Article
APA
Montinaro A, Gianfreda CD, Proto P.
(2007).
Equine pericardium for dural grafts: clinical results in 200 patients.
J Neurosurg Sci, 51(1), 17-19.
Publication
Researcher Affiliations
- Division of Neurosurgery, V. Fazzi Hospital, Lecce, Italy. a.montinaro@libero.it
MeSH Terms
- Animals
- Brain Injuries / surgery
- Brain Neoplasms / surgery
- Dura Mater / blood supply
- Dura Mater / injuries
- Dura Mater / surgery
- Fibroblasts / physiology
- Horses / anatomy & histology
- Horses / immunology
- Humans
- Meningeal Arteries / anatomy & histology
- Meningeal Arteries / physiology
- Neovascularization, Physiologic / physiology
- Neurosurgical Procedures / instrumentation
- Neurosurgical Procedures / methods
- Neurosurgical Procedures / trends
- Pericardium / anatomy & histology
- Pericardium / physiology
- Pericardium / transplantation
- Postoperative Complications / etiology
- Postoperative Complications / physiopathology
- Postoperative Complications / prevention & control
- Regeneration / physiology
- Subdural Effusion / etiology
- Subdural Effusion / physiopathology
- Subdural Effusion / prevention & control
- Suture Techniques / instrumentation
- Suture Techniques / standards
- Sutures / standards
- Tissue Adhesions / prevention & control
- Tissue Transplantation / instrumentation
- Tissue Transplantation / methods
- Tissue Transplantation / trends
- Transplantation, Heterologous / methods
- Treatment Outcome
Citations
This article has been cited 8 times.- Elassal AA, Al-Radi OO, Zaher ZF, Dohain AM, Abdelmohsen GA, Mohamed RS, Fatani MA, Abdelmotaleb ME, Noaman NA, Elmeligy MA, Eldib OS. Equine pericardium: a versatile alternative reconstructive material in congenital cardiac surgery. J Cardiothorac Surg 2021 Apr 23;16(1):110.
- Pasculli A, Gurrado A, De Luca GM, Mele A, Marzullo A, Mangone A, Cellamare S, Ferraro V, Maqoud F, Caggiani MC, Rana F, Cavallaro G, Prete FP, Tricarico D, Altomare CD, Testini M. Bridging repair of the abdominal wall in a rat experimental model. Comparison between uncoated and polyethylene oxide-coated equine pericardium meshes. Sci Rep 2020 Apr 24;10(1):6959.
- Centonze R, Agostini E, Massaccesi S, Toninelli S, Morabito L. A novel equine-derived pericardium membrane for dural repair: A preliminary, short-term investigation. Asian J Neurosurg 2016 Jul-Sep;11(3):201-5.
- Spiliopoulos K, Markakis C, Tomos P, Gakiopoulou H, Nikolopoulos I, Spartalis E, Kontzoglou K, Safioleas M. Repair of gastric defects with an equine pericardial patch. Surg Today 2015 Jan;45(1):83-90.
- Xu C, Ma X, Chen S, Tao M, Yuan L, Jing Y. Bacterial cellulose membranes used as artificial substitutes for dural defection in rabbits. Int J Mol Sci 2014 Jun 16;15(6):10855-67.
- Cavallo LM, Solari D, Somma T, Di Somma A, Chiaramonte C, Cappabianca P. Use of equine pericardium sheet (LYOMESH®) as dura mater substitute in endoscopic endonasal transsphenoidal surgery. Transl Med UniSa 2013;7:23-8.
- Vulev I, Klepanec A, Bazik R, Balazs T, Illes R, Steno J. Endovascular treatment of internal carotid and vertebral artery aneurysms using a novel pericardium covered stent. Interv Neuroradiol 2012 Jun;18(2):164-71.
- Asai K, Watanabe M, Matsukiyo H, Osawa A, Saito T, Kiribayashi T, Enomoto T, Nakamura Y, Okamoto Y, Saida Y, Kusachi S, Oharaseki T, Nagao J. Combined hepatic resection with the inferior vena cava and diaphragm and reconstruction using an equine pericardial patch: report of a case. Surg Today 2011 Dec;41(12):1670-3.
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