Neurosurgery Unit, Surgery Department, Faculty of Medicine, Ramathibodi Hospital , Bangkok, Thailand.
Department of Pharmacology, Faculty of Science, Mahidol University , Bangkok, Thailand.
Neurol Res. 2020 Oct;42(10):879-889. doi: 10.1080/01616412.2020.1789383. Epub 2020 Jul 13.
After a neurosurgical procedure, dural closure is commonly needed to prevent cerebrospinal fluids (CSF) leakage and to reduce the risk of complications, including infections and chronic inflammatory reactions. Although several dural substitutes have been developed, their manufacturing processes are complicated and costly and that many of them have been implicated in causing postoperative complications. This study aimed to assess the effectiveness and safety of new bilayer ORC/PCL composites in a rabbit model.
Two formulations of bilayer oxidized regenerated cellulose (ORC)/poly ε-caprolactone (PCL) knitted fabric-reinforced composites and an autologous graft (pericranium) were employed for dural closure in forty-five male rabbits. Systemic reaction and the local reaction of the samples were assessed and compared at one-, three- and six-months post-implantation by blood chemistry and gross, and microscopic assessment using hematoxylin-eosin and Masson's trichrome stains.
No signs of CSF leakage or systemic infection were seen for all samples. All samples demonstrated minimal adhesion to adjacent tissues. The degree of host fibrous connective tissue ingrowth into both composites was comparable to that of the autologous group, but bone formation and osteoclast activities were significantly greater. Both composites progressively degraded over times and the residual thickness of the nonporous layer was 50% of the initial thickness at six months post-implantation.
Bilayer ORC/PCL composites were successfully employed for dural closure in the rabbit model. They were biocompatible and could support dural regeneration comparable to that of the autologous group, but induced greater osteogenesis.
在神经外科手术后，通常需要进行硬脑膜闭合以防止脑脊液（CSF）渗漏并降低包括感染和慢性炎症反应在内的并发症风险。尽管已经开发出几种硬脑膜替代品，但它们的制造工艺复杂且昂贵，并且许多替代品都与术后并发症有关。本研究旨在评估新型双层 ORC/PCL 复合材料在兔模型中的有效性和安全性。
将两种双层氧化再生纤维素（ORC）/聚 ε-己内酯（PCL）编织物增强复合材料和自体移植物（颅骨膜）用于 45 只雄性兔的硬脑膜闭合。通过血液化学和大体及苏木精-伊红和 Masson 三色染色的组织学评估，在植入后 1、3 和 6 个月时评估和比较样品的全身反应和局部反应。
所有样本均未见 CSF 渗漏或全身感染迹象。所有样本均与相邻组织仅有轻微粘连。宿主纤维结缔组织向内生长到两种复合材料中的程度与自体组相当，但骨形成和破骨细胞活性明显更大。两种复合材料随时间逐渐降解，植入后 6 个月时非多孔层的残余厚度为初始厚度的 50%。
双层 ORC/PCL 复合材料成功应用于兔模型的硬脑膜闭合。它们具有生物相容性，能够支持与自体组相当的硬脑膜再生，但诱导了更大的成骨作用。
