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      Large retrospective study of artificial dura substitute in patients with traumatic brain injury undergo decompressive craniectomy

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          Abstract

          Background

          Decompressive craniectomy is widely used for treating patients with traumatic brain injury ( TBI). Usually patients have dura mater defect due to surgery or injury itself. The defective area may left open or repaired by artificial dura substitutes. A variety of artificial dura substitutes have been used for this purpose.

          Objective

          This study aimed to evaluate bovine‐derived pericardium membrane as artificial dural material for patients with decompressive craniectomy.

          Methods

          Totally 387 patients with severe TBI in our hospital were included in this study. Among them, 192 patients were treated with standard decompressive craniectomy without dura repair (control group). One hundred and ninety‐five TBI patients were treated with dura repair by artificial dura materials ( ADM). Nonlyophilized bovine pericardium membranes were used as artificial dura material. The postoperative complications were compared in both groups, including infection, seizure, and cerebrospinal fluid ( CSF) leakage.

          Results

          Patients in control group have higher complication rates than patients in ADM group, including subcutaneous hematoma (13.02% in control vs. 4.01% in ADM group, p = .004), infection (12.5% in control vs. 5.64% in ADM group, p = .021), CSF leakage (13.02% in control vs. 5.13% in ADM group, p = .012), and seizure (10.42% in control vs. 3.08% in ADM group, p = .007). Patients in ADM group are only associated with higher incidence of foreign body reaction (6 of 195 patients in ADM vs. none from control group).

          Conclusion

          Bovine‐derived pericardium membranes are successfully used as artificial dural substitutes for decompressive craniectomy. Patients with ADM have better clinical outcome than control group.

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          Most cited references47

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          Classification of traumatic brain injury for targeted therapies.

          Kathryn E Saatman, Ann-Christine Duhaime, Ross Bullock … (2008)
          The heterogeneity of traumatic brain injury (TBI) is considered one of the most significant barriers to finding effective therapeutic interventions. In October, 2007, the National Institute of Neurological Disorders and Stroke, with support from the Brain Injury Association of America, the Defense and Veterans Brain Injury Center, and the National Institute of Disability and Rehabilitation Research, convened a workshop to outline the steps needed to develop a reliable, efficient and valid classification system for TBI that could be used to link specific patterns of brain and neurovascular injury with appropriate therapeutic interventions. Currently, the Glasgow Coma Scale (GCS) is the primary selection criterion for inclusion in most TBI clinical trials. While the GCS is extremely useful in the clinical management and prognosis of TBI, it does not provide specific information about the pathophysiologic mechanisms which are responsible for neurological deficits and targeted by interventions. On the premise that brain injuries with similar pathoanatomic features are likely to share common pathophysiologic mechanisms, participants proposed that a new, multidimensional classification system should be developed for TBI clinical trials. It was agreed that preclinical models were vital in establishing pathophysiologic mechanisms relevant to specific pathoanatomic types of TBI and verifying that a given therapeutic approach improves outcome in these targeted TBI types. In a clinical trial, patients with the targeted pathoanatomic injury type would be selected using an initial diagnostic entry criterion, including their severity of injury. Coexisting brain injury types would be identified and multivariate prognostic modeling used for refinement of inclusion/exclusion criteria and patient stratification. Outcome assessment would utilize endpoints relevant to the targeted injury type. Advantages and disadvantages of currently available diagnostic, monitoring, and assessment tools were discussed. Recommendations were made for enhancing the utility of available or emerging tools in order to facilitate implementation of a pathoanatomic classification approach for clinical trials.
          Article 0 comments Cited 266 times – based on 0 reviews     Review now
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            Preparation and rheological characterization of a gel form of the porcine urinary bladder matrix.

            Shin-Seok Lee, Jeffrey Martin Coil, S. Velankar … (2008)
            Biologic scaffolds composed of extracellular matrix (ECM) have been used to facilitate the repair and reconstruction of a variety of tissues in clinical and pre-clinical studies. The clinical utility of such scaffolds can be limited by the geometric and mechanical properties of the tissue or organ from which the ECM is harvested. An injectable gel form of ECM could potentially conform to any three-dimensional shape and could be delivered to sites of interest by minimally invasive techniques. The objectives of the present study were to prepare a gel form of ECM harvested from the urinary bladder (urinary bladder matrix or UBM), to characterize the rheological properties of the gel, and finally to evaluate the ability of the gel to support in vitro growth of smooth muscle cells. Following enzymatic solubilization with pepsin, UBM was induced to self-assemble into a gel when brought to physiological conditions. The UBM gel supported the adhesion and growth of rat aortic smooth muscle cells when cultured under static in vitro conditions. The present study showed that an intact form of UBM can be successfully solubilized without purification steps and induced to repolymerize into a gel form of the UBM biologic scaffold material.
            Article 0 comments Cited 140 times – based on 0 reviews     Review now
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              Incidence of traumatic brain injury in the United States, 2003.

              Wesley Rutland-Brown, Jean A Langlois, Karen Thomas … (2015)
              Traumatic brain injury (TBI) is an important public health problem in the United States. In 2003, there were an estimated 1,565,000 TBIs in the United States: 1,224,000 emergency department visits, 290,000 hospitalizations, and 51,000 deaths. Findings were similar to those from previous years in which rates of TBI were highest for young children (aged 0-4) and men, and the leading causes of TBI were falls and motor vehicle traffic.
              Article 0 comments Cited 105 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Sai Zhang:
                ORCID: http://orcid.org/0000-0001-7329-1679
                zhangsai718@vip.126.com
                Journal
                Journal ID (nlm-ta): Brain Behav
                Journal ID (iso-abbrev): Brain Behav
                Journal ID (doi): 10.1002/(ISSN)2157-9032
                Journal ID (publisher-id): BRB3
                Title: Brain and Behavior
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2162-3279
                Publication date (Electronic): 25 March 2018
                Publication date Collection: May 2018
                Volume: 8
                Issue: 5 ( doiID: 10.1002/brb3.2018.8.issue-5 )
                Electronic Location Identifier: e00907
                Affiliations
                [ 1 ] Sixth Department of Neurosurgery, Brain Center Affiliated Hospital of Logistics University of People's Armed Police Force Tianjin China
                [ 2 ] Division of Clinical Medicine Chongqing Medical University Chongqing China
                [ 3 ] Brain Center Affiliated Hospital of Logistics University of People's Armed Police Force Tianjin China
                Author notes
                [*] [* ] Correspondence

                Sai Zhang, Sixth Department of Neurosurgery, Brain Center, Affiliated Hospital of Logistics University of People's Armed Police Force, Tianjin, China.

                Email: zhangsai718@ 123456vip.126.com

                [†]

                Co‐first authors: Hongtao Sun and Hongda Wang

                Author information
                http://orcid.org/0000-0001-7329-1679
                Article
                Publisher ID: BRB3907
                DOI: 10.1002/brb3.907
                PMC ID: 5943738
                PubMed ID: 29761002
                SO-VID: 649ff863-52aa-4b96-a726-8222239eedef
                Copyright © © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 19 June 2017
                Date revision received : 26 October 2017
                Date accepted : 09 November 2017
                Page count
                Figures: 0, Tables: 3, Pages: 7, Words: 5251
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 814712751004949
                Funded by: Tianjin Science and Technology Plan Project
                Award ID: 17YFZCSY00620
                Categories
                Subject: Original Research
                Subject: Original Research
                Custom metadata
                source-schema-version-number 2.0
                component-id brb3907
                cover-date May 2018
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.7.2 mode:remove_FC converted:10.05.2018

                ScienceOpen disciplines: Neurosciences
                Keywords: artificial dura material,bovine‐derived pericardium decompressive craniectomy,traumatic brain injury
                Data availability:
                ScienceOpen disciplines: Neurosciences
                Keywords: artificial dura material, bovine‐derived pericardium decompressive craniectomy, traumatic brain injury

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