It was reported via journal article: title: "dural repair using acellular human dermis: experience with 200 cases: technique assessment." authors: warren, w.Lee m.D.; medary, max b.M.D.; dureza, catalino d.M.D.; bellote, j.Brad m.D.; flannagan, patrick p.M.D.; oh, michael y.M.D.; fukushima, takanori m.D.Citation: neurosurgery.2000; 46 (6): pp 1391 ¿ 1396.The authors performed 200 craniotomies using an acellular human dermal graft to determine the suitability of the device as a dural substitute.The goal in using a dural substitute is to achieve a watertight closure, to prevent infection, and to provide a surface along which the body can generate neodura.From june 1996 through march 1998, all patients at the allegheny general hospital who required a dural substitute graft and in whom autograft harvest was impractical or impossible received acellular dermal autograft.During the surgical procedure, after the dural substitute is inserted, a running nurolon 4-0 suture (ethicon) was used to secure it to the dura or cranium.Reported complications included superficial wound infection (n-4) which required subsequent surgery, post-operative csf leaks (n-3) in which did not resolved with lumbar drain placement.These patients returned to the operating room for exploration; 2 underwent craniotomy and 1 patient underwent endoscopic transnasal exploration, and a (b)(6) caucasian man with csf leak with no response to lumbar drainage and returned to the operating room for an endoscopic exploration.The authors have gained considerable experience with the acellular human dermis.The material behaves very much like dura in situ, in that it does not induce adhesion formation or rejection.It was concluded that the device is a safe, cost-effective material, with obvious advantages over other dural substitute products.It has demonstrated clinical efficacy, with no apparent risks of transmission, inflammation, or rejection.
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