Comparison of Biomechanical Properties of Dura Mater Substitutes and Cranial Human Dura Mater : An In Vitro Study

Abstract

ObjectiveThe aim of this study was to investigate the biomechanical differences between human dura mater and dura mater substitutes to optimize biomimetic materials. MethodsFour groups were investigated. Group I used cranial dura mater (n=10), group II used Gore-Tex® Expanded Cardiovascular Patch (W.L. Gore & Associates Inc., Flagstaff, AZ, USA) (n=6), group III used Durepair® (Medtronic Inc., Goleta, CA, USA) (n=6), and group IV used Tutopatch® (Tutogen Medical GmbH, Neunkirchen am Brand, Germany) (n=6). We used an axial compression machine to measure maximum tensile strength. ResultsThe mean tensile strengths were 7.01±0.77 MPa for group I, 22.03±0.60 MPa for group II, 19.59±0.65 MPa for group III, and 3.51±0.63 MPa for group IV. The materials in groups II and III were stronger than those in group I. However, the materials in group IV were weaker than those in group I. ConclusionAn important dura mater graft property is biomechanical similarity to cranial human dura mater. This biomechanical study contributed to the future development of artificial dura mater substitutes with biomechanical properties similar to those of human dura mater.

Performance evaluation of bilayer oxidized regenerated cellulose/poly ε-caprolactone knitted fabric-reinforced composites for dural substitution

“…These differences were related to the use of PLLA as a raw material for ReDuraä which has greater mechanical properties and density than collagen that was used by DuraGen Plusä. Mean tensile modulus and strength of human cadaveric dura mater in this study were 65.51 and 4.43 MPa, respectively, which were within the similar ranges of fresh human cranial dura mater 22 and thus could be employed as a gold standard for benchmark comparison. The microstructure of human cadaveric dura mater was neither porous nor dense, but rather a combination of both microstructures by consisting of elastic Type I collagen fibers in a matrix of mucopolysaccharides.…”

A Randomised Interventional Study to Compare Autologous and Nonautologous Dural Substitutes Among Traumatic Brain Injury Patients

“…The latest report in 2019 said that Gore-Tex Expanded Cardiovascular Patch and Durepair, USA, have better biomechanical strength with similar thickness, impact absorbency and elasticity as human dura mater. 4 Almost to the index study, the use of double layer G-patch has been reinforced in the one of the latest published studies 19 where it was shown that double-layer G-patch during DC facilitates subsequent cranioplasty by preventing adhesions between the layers, resulting in easier dissection and reduced blood loss. The current and other study results support the importance of use of autologous grafts and the G-patch in the current growing era of innovation of newer graft materials.…”

“…3 An ideal dural substitute should be non-neurotoxic, nonimmunogenic, noninflammatory, nonviral/prion, nonadhesive to other tissues, watertight, viscoelastic, and biomechanically resistant. 4 Human dura has collagen and elastin and is the most appropriate viscoelastic dural substitute, which fulfills all the criteria, as it is autologously derived from the galea-pericranium, fascia lata, fat, or temporal fascia. Few of the shortcomings in the use of autologous human dura include prolonged time of collection and retrieval, creation of an additional incision, and insufficiency to fill large dural defects.…”

Composite chitosan/polyethylene oxide film for duraplasty in traumatic brain injury model in rats

“…In 1924, W. Penfield proposes the concept of "ideal dura mater substitute" [8,9] which was further developed, for example in the work of O. Arutyunov, N. Meskhia [10]. The substitute must be non-toxic, biodegradable, and suitable for suturing; not lead to commissure or infection; create a waterproof barrier; to have antibacterial properties at penetrating trauma; and should be at a reasonable price [11,12]. The development of modern new polymeric materials stimulates the search for new opportunities in creating an effective substitute for DM [11].…”

“…To improve the dural closure, various materials of autologous, allogeneic, xenogeneic and synthetic origin were tested [12][13][14]. Autologous grafts are non-toxic, quickly integrated in host tissues, flexible, durable and easily sutured [15][16][17].…”