Apply Bioabsorbable Duragen Patch To Treat Dura Mater Defect

Dura mater,which constitutes an important and natural barrier to protect the brain tissue,is a thick and tough double membranous tissue between skull and brain[1].Trauma,inflammation,tumor erosion and surgery can lead to dural defect,breaking its integrity.Duraplasty is necessary to maintain its anatomic integrity and protect the brain tissue.Such as in Crouzon syndrome and Apert syndrome,craniosynostosis lead to narrow cranial cavity deformity and increased intracranial pressure[35-36].The surgery of releasing?rearranging and fixing skull crack in the cranial treatment is easy to destroy the integrity of the dura mater.The materials of repairing dura mater defect directly affects the incidence of complications,such as intracranial infection,epilepsy,brain tissue bulging,cerebrospinal fluid leakage and appearance.For a long time,the research for an ideal dural repair material is uninterrupted.New idea,new material and new method about dura repair are also advancing with times.Objective:Through observing of the absence of dura in the process of cranial suture releasing,skull shape remodeling,we applied the artificial dura mater collagen fiber patch DuraGen to repair the defect of dura,so as to reduce the surgical trauma,and reduce the incidence of complications,such as postoperative intracranial infection,epilepsy,brain tissue bulging,such as cerebrospinal fluid leakage.Method:This clinical study focus on two cases:"Crouzon syndrome" and "oblique head deformities".The two patients,admitted to our department,received the operation of" craniosynostosis release,cranial cavity expansion,cranioplasty;osteotomy of frontal-orbit moving forward,skull deformity correction,small titanium nail and titanium plate fixation" respectively.During the operation,both patients' dura were defect.We apply biological and absorbable DuraGen dura patch to rapire the defect of dura mater.Results:Two patients all recovered well postoperatively,no intracranial infection,epilepsy,brain tissue bulging,cerebrospinal fluid leakage and other complications.Implanted DuraGen patch is stable and appears no rejection,infection,and so on.Postoperative review of skull CT and three-dimensional reconstruction shows a stable condition with no bleeding and infected focal.Conclusion:Using collagen fiber DuraGen patch to repair the dura mater defect,compared with other dural substitute materials,DuraGen patch,with the property of stable structure?good compatibility?fully biodegradable?non-toxic?slightly immune response?sutureless or tightly suture,can prevent postoperative adhesion,cerebrospinal fluid leak and intracranial infection of incision effectively.DuraGen dura patch is convenient to use with high satisfaction.From January 2014 to October 2016,we use such dural repair materials respectively in two patients'defected dura mater,and relatively satisfactory clinical results have been achieved.