Abstract
Objective. To study cerebrospinal fluid (CSF) changes after the duraplasty with autologous fascia, collagen-based material and chitin-chitosan membrane in early and late postoperative periods. Materials and methods. Chitosan-based films were made out of 3 % solution of chitosan for the research. We used 200 kDa chitosan (deacetylation rate 80–90 %) to produce chitin-chitosan membrane by using solvent evaporation method. For enhancing mechanical properties and reducing the degradation, chitin particles were added to the chitosan solution. Chitosan and chitin ratio was 80/20. The chitin/chitosan solution in Petri dishes was being dried out during 3 days at room temperature. Cerebrospinal fluid composition has been studied after the duraplasty with autofascia, collagen-based material and innovative chitosan-based graft in early and late postoperative periods. The duraplasty was performed by applying these materials to 90 Chinchilla rabbits breed. Animals were divided into three groups: I group — duraplasty using the fascia lata autograft, II group — duraplasty with the collagen-based material, III group — duraplasty using the chitin-chitosan membrane. The animals in the II and III groups were divided into 2 subgroups: A — plasty without fixing the material, B — plasty with fixing the material using atraumatic suture. CSF composition was studied before and after the operation had been performed in 2 weeks, 2 and 6 months. Results. The results of our study demonstrated the increase in density and protein level, the decrease in рН and glucose level and the extreme increase of cells, mostly neutrophils after the use of fascia lata for dural closure. At the same time, there were no substantial changes after dural closure with artificial collagen- and chitosan-based materials, the CSF composition normalized in 2 months after operation. Conclusion. The use of autologous fascia for duraplasty leads to an acute response of the cerebrospinal fluid in the early postoperative period and to residual pleocytosis. The chitosan-based graft application was followed by no complications at 6 months after surgery and only slight CSF response in the early postoperative period. There wasn’t any significant difference in CSF composition in chitosan- and the collagen-based material usage. Given the lack of changes in SCF tests between suture and no suture graft fixation except for a slight increase in erythrocyte number in the early postoperative period, the choice of material fixation method is entirely dependent on the clinical situation and does not affect the cerebrospinal fluid state.
Highlights
The need for substitution of lost native dural tissue arises in the presence of its traumatic or neoplastic destruction, after operative procedures, when the dura mater is involved [1,2,3]
There were no substantial changes after dural closure with artificial collagen- and chitosan-based materials, the cerebrospinal fluid (CSF) composition normalized in 2 months after operation
CSF became less clear after 2 weeks after the duraplasty with fascia lata, density increased up to 1.014 (p =0.034), which could indicate both bacterial inflammation and reaction to the foreign body
Summary
The need for substitution of lost native dural tissue arises in the presence of its traumatic or neoplastic destruction, after operative procedures, when the dura mater is involved [1,2,3]. The applying of patient’s fascia lata is the classic method This technique has its advantages due to the absence of an immune response to the native material, ease of execution and lack of the financial burden on the patient or clinic. Both the probability of postoperative complications and an additional trauma limit the use of this technique [4, 5]. Biocompatible implants can be developed on the base of natural polysaccharide chitosan and its derivatives [8]. There is a few of information concerning the use of chitosan-based materials as a dural substitute
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
