Equine pericardium for dural grafts: clinical results in 200 patients.
OBJECTIVE
Serous sheets are currently used in Neurosurgery as dural substitute. The aim of this study is to demonstrate that the horse pericardium, which has the essential charasteristics of reabsorbable membranes and moreover is BSE-free, is an excellent dural substitute.


METHODS
200 patients, 53 suffering from cranial traumatic conditions and 97 from cranial and craniospinal neoplastic pathologies, underwent a surgical procedure with the application of horse pericardium as a dural prosthesis.


RESULTS
The follow-up controls of the patients included a neurosurgical visit and advanced diagnostic imaging (CT or MR). In the first 3 cases, an accumulation of CSF occurred under the surgical edge. Lumbar 7-days drainage was required in just one case. The use of Zero 5 suture seems to have obviated this problem, as it was never observed again in subsequent cases. The diagnostic imaging showed no alterated images and no clinical-neurological sequelae regarding the prosthesis in question were recorded.


CONCLUSIONS
The Audiomesh Neuro prosthesis has all the characteristics of reabsorbable membranes: they are free from antigenic effects and do not produce any toxic catabolites. The membrane proved to be resistant to surgical suture, impermeable to CSF and is transparent. Yet the suture must be carried out carefully through a small non-traumatic needle. Audiomesh Neuro does not adhere to the underlying cerebral cortex and does not cause any clinical evidence or radiological artifacts.
Montinaro
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Division of Neurosurgery, V. Fazzi Hospital, Lecce, Italy. a.montinaro@libero.it
Gianfreda
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D000818:Animals; D001930:Brain Injuries / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D004388:Dura Mater / Q000098:blood supply / Q000293:injuries / Q000601:surgery*; D005347:Fibroblasts / Q000502:physiology; D006736:Horses / Q000033:anatomy & histology* / Q000276:immunology*; D006801:Humans; D008576:Meningeal Arteries / Q000033:anatomy & histology / Q000502:physiology; D018919:Neovascularization, Physiologic / Q000502:physiology; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D010496:Pericardium / Q000033:anatomy & histology / Q000502:physiology / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012038:Regeneration / Q000502:physiology; D013353:Subdural Effusion / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013536:Suture Techniques / Q000295:instrumentation / Q000592:standards; D013537:Sutures / Q000592:standards; D000267:Tissue Adhesions / Q000517:prevention & control; D016378:Tissue Transplantation / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D014183:Transplantation, Heterologous / Q000379:methods*; D016896:Treatment Outcome