Use of spongostan on prevention of cranial subdural adhesions following craniotomy in a rabbit model

Abstract

AIm: Spongostan™ is a sterile, water-insoluble, porcine gelatin absorbable sponge, which is widely used as a hemostatic material. The aim of this study is to test the anti-fibrotic capacity of Spongostan™, using a craniotomy model in an experimental rabbit model. mAterIAl and methOds: Eighteen rabbits were divided into two groups: Each group consisted of 9 rabbits, duratomy plus Spongostan™ (group 1), and duratomy without Spongostan™ (group 2). Right parietal bone was removed via trephine and low speed drill and dura was opened. On the group 1 rabbits, an appropriate piece of Spongostan™ was meticulously placed under dural layer. On group 2 rabbits, same procedures were repeated without Spongostan™. Histological sections were taken from each group and evaluated for degree of fibrosis and collagen fibers. results:There was marked increase in number of fibroblasts and collagen fibers in group 2 rabbits, however most of the rabbits in Spongostan™ group demonstrate scarce histopathological findings for fibrosis. COnClusIOn:We conclude that an appropriately placed subdural Spongostan™ over cerebral tissue may prevent postoperative surgical adhesions after neurosurgical operations.

Large Isolated Nasoorbital Type of Frontoethmoidal Encephalomeningocele

“…In this patient, gel foam acted as temporary orbital floor obliteration to prevent orbital dystopia and enophthalmos through fibrosis mechanisms. [17][18][19][20] Monitoring in the postoperative period is important in neurological aspects because of reported complications, such as meningitis/encephalitis or increased intracranial pressure, which were not found in this case. The patient's postoperative recovery was uneventful, with noted improvement.…”

“…Generally, the direction of fixation is variable, but in this patient, it was fixed in the superoposterior direction, after normal anatomical attachment. In this patient, gel foam acted as temporary orbital floor obliteration to prevent orbital dystopia and enophthalmos through fibrosis mechanisms 17–20 . Monitoring in the postoperative period is important in neurological aspects because of reported complications, such as meningitis/encephalitis or increased intracranial pressure, which were not found in this case.…”

Hydrophobic Polystyrene‐Modified Gelatin Enhances Fast Hemostasis and Tissue Regeneration in Traumatic Brain Injury

“…It is sometimes placed subdurally over cerebral tissue to prevent postoperative surgical adhesions. [ 32 ] However, hemostasis time of gelatin sponge takes longer as shown in Figure 4B,C. Also, it was pointed that epidural fibrosis developed more often with the use of gelatin sponge.…”

The role of hemostatic devices in neurosurgery. A systematic review

“…Gelatin sponges are sterile, water-insoluble, and porcine gelatin absorbable sponges, widely used as a hemostatic material [18]. Among several products nowadays available on the market, Spongostan TM (Ferrosan Medical Devices A/S, Søborg, Denmark), Surgifoam Ò (Ethicon Inc., Somerville, NJ, USA) or Gelfoam Ò (Pfizer Inc., Brooklyn, NY, USA) represent the most commonly used in many surgeries.…”

“…Besides conventional hemostatic purpose, it has been suggested that gelatin sponge may be used to self-make an effective and inexpensive flowable gelatin paste, which can be adopted safely in neurosurgery alone or combined with other hemostatics [19,20]. Moreover, an appropriately placed subdural gelatin sponge over cerebral tissue may prevent postoperative surgical adhesions after neurosurgical procedures [18]. However, it has been reported that gelatin sponges may be related to increased odds of epidural fibrosis [21][22][23], and care must be taken when they are used in confined space because of their absorption capability and the related swelling of the sponge.…”