Safety and Efficacy of a Novel, Self-Adhering Dural Substitute in a Canine Supratentorial Durotomy Model

Lewis, Kevin M.; Sweet, Jenifer; Wilson, Scott; Rousselle, Serge; Gulle, Heinz; Baumgartner, Bernhard

doi:10.1093/neuros/nyx216

Cited by 23 publications

(20 citation statements)

References 53 publications

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“…1 ). The collagen sheet is 0.5 cm in thickness composed of collagen layers having a hexagonal and honeycomb-like spatial structure [ 25 , 26 ]. Its degradation time is reported to be within 12 weeks when the dressing was placed onto the rat pleura [ 27 ]; however, this is subject to the surrounding circumstances [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

On-site fabrication of Bi-layered adhesive mesenchymal stromal cell-dressings for the treatment of heart failure

et al. 2019

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Mesenchymal stromal/stem cell (MSC)-based therapy is a promising approach for the treatment of heart failure. However, current MSC-delivery methods result in poor donor cell engraftment, limiting the therapeutic efficacy. To address this issue, we introduce here a novel technique, epicardial placement of bi-layered, adhesive dressings incorporating MSCs (MSC-dressing), which can be easily fabricated from a fibrin sealant film and MSC suspension at the site of treatment. The inner layer of the MSC dressing, an MSC-fibrin complex, promptly and firmly adheres to the heart surface without sutures or extra glues. We revealed that fibrin improves the potential of integrated MSCs through amplifying their tissue-repair abilities and activating the Akt/PI3K self-protection pathway. Outer collagen-sheets protect the MSC-fibrin complex from abrasion by surrounding tissues and also facilitates easy handling. As such, the MSC-dressing technique not only improves initial retention and subsequent maintenance of donor MSCs but also augment MSC's reparative functions. As a result, this technique results in enhanced cardiac function recovery with improved myocardial tissue repair in a rat ischemic cardiomyopathy model, compared to the current method. Dose-dependent therapeutic effects by this therapy is also exhibited. This user-friendly, highly-effective bioengineering technique will contribute to future success of MSC-based therapy.

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Section: Introductionmentioning

confidence: 99%

On-site fabrication of Bi-layered adhesive mesenchymal stromal cell-dressings for the treatment of heart failure

et al. 2019

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“…As a topical sealing hemostat, this polyethylene glycol-covered matrix has already been evaluated in general surgery [8, 10] and in cardiac surgery [11]. The clinical results were encouraging, and no relevant neurotoxic complications were documented in animal testing [15].…”

Section: Discussionmentioning

confidence: 99%

Clinical Experience with Hemopatch® as a Dural Sealant in Cranial Neurosurgery

Schebesch¹,

Brawanski²

2019

Cureus

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Background: Herein, we report our clinical experience with the novel polyethylene glycol-covered matrix dural onlay, Hemopatch® (Baxter Deutschland GmbH, Unterschleißheim, Germany) for the prevention of postoperative cerebrospinal fluid (CSF) fistulas. Methods: Retrospectively, 22 consecutive patients (11 females, 11 males, mean age: 49.8 years, range: 15–77 years) with oncological and vascular intracranial lesions were included in this study. In all patients, the Hemopatch was applied as the dural onlay. The accuracy of the primary dural sutures was distinguished into 1) no visible gaps, 2) small gaps < 3 mm, and 3) large gaps > 3 mm. We evaluated the patient charts, surgical reports, and postoperative images. The median follow-up was three months. We recorded any wound healing disorder, such as infection or CSF fistula, and postoperative hemorrhage resulting in surgical revision. Results: Supratentorial, infratentorial, and transsphenoidal approaches were conducted in 17, four, and one patient, respectively. Accurate sutures without visible gaps, small gaps, and large gaps were covered with the Hemopatch in 11, eight, and three patients. One patient developed a CSF fistula (4.5%), one patient had a wound infection (4.5%), and in one patient, a remote cerebellar hemorrhage occurred (unrelated to the dural closure) (4.5%). Thus, the surgical revision rate due to wound healing disorders was 9% (2/22). Conclusion: It is safe and feasible to use the Hemopatch as a dural sealant. The rate of postoperative wound healing disorders in our population was in the lower range of reported surgical revision rates after supra-/infratentorial craniotomies. However, prospective and controlled clinical trials are still warranted.

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“…The high porosity of the graft is thought to aid fibroblast migration and vascularization. The collagen sponge dural graft has been shown to strengthen the integration of the graft with native tissue in the previous study [25]. Collagen has also been shown to enhance the survival of CNS neurons and suppress apoptosis in culture [26, 27].…”

Section: Discussionmentioning

confidence: 99%

Neuroprotective Effects of Collagen-Glycosaminoglycan Matrix Implantation following Surgical Brain Injury

Chen

Hsu

Huang

2019

Mediators of Inflammation

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Background. Neurological deficits following neurosurgical procedures are inevitable; however, there are still no effective clinical treatments. Earlier reports revealed that collagen-glycosaminoglycan (CG) matrix implantation promotes angiogenesis, neurogenesis, and functional recovery following surgical brain injury (SBI). The present study was conducted to further examine the potential neuroprotective effects of collagen-glycosaminoglycan (CG) matrix implantation following neurosurgery. Methods. CG implantation was performed in the lesion cavity created by surgical trauma. The Sprague-Dawley rat model of SBI was used as established in the previous study by the author. The rats were divided into three groups as follows: (1) sham (SHAM), (2) surgery-induced lesion cavity (L), and (3) CG matrix implantation following surgery-induced lesion cavity (L+CG). Proinflammatory (tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells)) and anti-inflammatory (IL-10 and granulocyte-macrophage colony-stimulating factor (GMCSF)) cytokine expression was evaluated by enzyme-linked immunosorbent assays. Microglial activation was evaluated by immunohistochemistry, and the neuroprotective effect of CG matrix implantation was evaluated by an immunohistochemical study of microglia ED-1 and IBA-1 (activated microglia) and myeloperoxidase (MPO) and by the analysis of IL-6, IL-10, TNF-α, NF-κB, and GMCSF cytokine levels. Apoptosis was also assessed using a TUNEL assay. Results. The results showed that CG matrix implantation following surgically induced lesions significantly decreased the density of ED-1, IBA-1, and MPO (activated microglia). The tissue concentration of proinflammatory cytokines, such as TNF-α, IL-6, and NF-κB was significantly decreased. Conversely, the anti-inflammatory cytokines GMCSF and IL-10 were significantly increased. Conclusions. Implantation of the CG matrix following SBI has neuroprotective effects, including the suppression of microglial activation and the production of inflammatory-related cytokines.

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Safety and Efficacy of a Novel, Self-Adhering Dural Substitute in a Canine Supratentorial Durotomy Model

Cited by 23 publications

References 53 publications

On-site fabrication of Bi-layered adhesive mesenchymal stromal cell-dressings for the treatment of heart failure

On-site fabrication of Bi-layered adhesive mesenchymal stromal cell-dressings for the treatment of heart failure

Clinical Experience with Hemopatch® as a Dural Sealant in Cranial Neurosurgery

Neuroprotective Effects of Collagen-Glycosaminoglycan Matrix Implantation following Surgical Brain Injury

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