Biomechanical characterization of human temporal muscle fascia in uniaxial tensile tests for graft purposes in duraplasty

Johann Zwirner,Niels Hammer,Benjamin Ondruschka,Mario Scholze,Gundula Schulze-Tanzil

doi:10.1038/s41598-020-80448-1

Abstract

The human temporal muscle fascia (TMF) is used frequently as a graft material for duraplasty. Encompassing biomechanical analyses of TMF are lacking, impeding a well-grounded biomechanical comparison of the TMF to other graft materials used for duraplasty, including the dura mater itself. In this study, we investigated the biomechanical properties of 74 human TMF samples in comparison to an age-matched group of dura mater samples. The TMF showed an elastic modulus of 36 ± 19 MPa, an ultimate tensile strength of 3.6 ± 1.7 MPa, a maximum force of 16 ± 8 N, a maximum strain of 13 ± 4% and a strain at failure of 17 ± 6%. Post-mortem interval correlated weakly with elastic modulus (r = 0.255, p = 0.048) and the strain at failure (r = − 0.306, p = 0.022) for TMF. The age of the donors did not reveal significant correlations to the TMF mechanical parameters. Compared to the dura mater, the here investigated TMF showed a significantly lower elastic modulus and ultimate tensile strength, but a larger strain at failure. The human TMF with a post-mortem interval of up to 146 h may be considered a mechanically suitable graft material for duraplasty when stored at a temperature of 4 °C.

Highlights

The human temporal muscle fascia (TMF) is used frequently as a graft material for duraplasty
We investigated the biomechanical properties of chemically unfixed human TMF samples at a broad age range as part of the Human Head Tissue Mechanics Project
TMF had an elastic modulus of 36 ± 19 MPa, an ultimate tensile strength of 3.6 ± 1.7 MPa, a maximum force of 16 ± 8 N, a maximum strain of 13 ± 4% and a strain at failure of 17 ± 6%

Summary

Introduction

The human temporal muscle fascia (TMF) is used frequently as a graft material for duraplasty. We investigated the biomechanical properties of 74 human TMF samples in comparison to an age-matched group of dura mater samples. None of these has so far been identified to be superior over the other materials[7] Fascial tissues such as the temporal muscle fascia (TMF)[8], the fascia lata[2], the cervical fascia9, pericardium[10] or p ericranium[11] are used as graft materials given their structural similarities with the collagen-rich dura mater. The TMF is the most accepted autologous graft material for duraplasty, as no additional incisions are necessary for its harvest during surgery It is a thin and pliable tissue and can be dissected [8,12,13]. Given that collagens are known to be subjected to age-related changes in other regions (e.g. by cross-linking or the formation of advanced glycation end-products)[20], it is hypothesized that the mechanical parameters significantly change with age

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Discussion

Conclusion