Comparative analysis of dural substitute autologous vs. semisynthetic collagen-based dura graft

Z. Khan, S. Pervez, S. Sharafat

Department of Neurosurgery, Lady Reading Hospital, Peshawar, Pakistan. Seemasharafat@yahoo.com

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• Neurosurgery

OBJECTIVE: The aim of the present study is to evaluate the success rate and safety of both auto-grafts and collagen-based semi-synthetic grafts in patients with dura defects.

PATIENTS AND METHODS: A prospective comparative study was conducted at the neurosurgery departments of different hospitals in Peshawar and Faisalabad. Patients were divided into two groups: A (autologous graft) and B (semi-synthetic graft). Dura graft autologous was applied in one group of patients with supratentorial brain surgery. Fascia lata was used, harvested from the lateral thigh, 3 to 5 cm long incision at the junction of the upper and middle one-third of the upper leg. A bone flap was implanted in the subcutaneous region in the abdominal part. Perioperative antibiotics were given to all the patients, and surgical drains placed intraoperatively were removed after 24 hours of surgery. In the second group, semi-synthetic dura grafts of 2.5×2.5 cm and 5×5 cm 7.5×7.5 cm sizes were used. Statistical analysis was performed using SPSS version v.20. Student’s t-test was performed for the two groups to compare categorical variables, and the data were considered statistically significant at p > 0.05.

RESULTS: In this study, 72 patients of both genders were recruited. We observed that the Semi-synthetic collagen matrix had less surgical time. The mean difference in surgical duration was observed as 40 minutes. However, both groups reported statistically significant differences in terms of surgical duration (< 0.001). No case of infection was reported in both groups. The overall mortality ratio was 12%. Two male deaths were recorded due to cardiovascular disorders, while one death of a 42-year male was also recorded.

CONCLUSIONS: Based on the above findings, it may be concluded that using a semi-synthetic collagen substitute for dura repair is a simple, safe, and effective alternative to the autologous graft for dura repair in dura defects.

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