Comparison between homemade artificial dura mater and USA product of the same kind

Objective To observe and compare the prognosis of the reparation of the injured dura with the innovative homemade artificial dura mater or with the the same kind of product named Dura-Guard imported from USA. Methods Clinically 39 patients, 24 underwent the skull surgical operations of replacing the orthotopic dura mater with the homemade material, and 15 with the Dura-Guard. In laboratory, 10 dogs were divided into 5 groups with 2 in each group according to the observation time (1, 6, 12, 24 months or longer respectively). The dura mater of each dog on both the right and left top of its head was replaced by implanting respectively the homemade material and the Dura-Guard. After the operation, the prognosis of the different implantations in the animals in each group was observed. Results The anatomy of the dogs showed a little bit easily detachable adhesion of the outer surface of the homemade material to the skull periosteum. The dog's orthotopic dura mater sutured around got cured completely, without visible interface between the implanted dura and the orthotopic dura mater. The inner surface of the homemade material and the Dura-Guard showed that the growth of the former is much closer to the orthotopic dura mater, with no adhesion or occasional filamentous adhesion to the brain surface. Histological and microscopic observations of both implantations did not show inflammatory cells such as neutrophil cells, lymphoid cells, and so on, and cyst wall at the interface between them and the dura mater. The inner surface of the homemade material was seen to be covered with epithelial cells. The proliferations of the fibrous tissues and fibroblasts were seen under the epithelia. The implanted homemade material was degraded with a distinct reduction in its total amount. Capillaries were seen inside the material. Conclusion After the operation of the homemade dura mater reparation, we found that the nature of this artificial duramater allowed epithelial cells to grow as well as avoided the adhesion to the brain tissues and would gradually be encroached, degraded and replaced by the recipient's autologous tissues so that the dura mater could be reconstructed in a practical way.