Comparison of the efficiency, side effects and complications of the synthetic dural grafts: Beriplast and Tissudura

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The purpose of this study was to compare human fibrinogen-thrombin-based liquid dural graft; Beriplast® (Behring, Malburg, Germany) and collagen-based dural graft; Tissudura® (Baxter, Heidelberg, Germany) in terms of efficiency, side effects and complications. Thirty Spraque Dawley rats were used in this experimental study. A burrhole was opened on the left parietal bone of each subject and experimental dural defect was created. While 10 subjects were in sham group without any dural defect repair, dural defect was repaired by Beriplast in 10 subjects, by Tissudura in 10 subjects. After twenty-one day follow-up, edema, gliosis and inflammatory cell infiltration in the parenchyma, foreign body reaction in the bone, fibrosis in the epidural space and dura were evaluated histopathologically. Beriplast caused much more severe inflammation on cortex. When we compared Tissudura group with the sham group in terms of parenchymal edema and gliosis, the difference was not significant. On the other hand, we have found a significant increase in cortical parenchymal edema in Beriplast group. The last generation dural grafts result in different degrees of the tissue reaction. Severe inflammatory reaction can provide more satisfactory results in terms of watertight dural closure but on the other hand, the same reaction can be a disadvantage to the surrounding tissue. 


Beriplast; dural defect; dural graft; tissudura

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