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Photosealing of dural defects using a biocompatible patch

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Abstract

Purpose

Photosealing of many biological tissues can be achieved using a biocompatible material in combination with a dye that is activated by visible light to chemically bond over the tissue defect via protein cross-linking reactions. The aim of this study was to test the efficacy of photosealing using a commercially available biomembrane (AmnioExcel Plus) to securely close dural defects in comparison to another sutureless method (fibrin glue) in terms of repair strength.

Methods

Two-millimeter diameter holes were created in dura harvested from New Zealand white rabbits and repaired ex vivo using one of two methods: (1) in n = 10 samples, photosealing was used to bond a 6-mm-diameter AmnioExcel Plus patch over the dural defect, and (2) in n = 10 samples, fibrin glue was used to attach the same patch over the dural defect. Repaired dura samples were then subjected to burst pressure testing. Histological analysis was also performed of photosealed dura.

Results

The mean burst pressures of rabbit dura repaired with photosealing and fibrin glue were 302 ± 149 mmHg and 26 ± 24 mmHg, respectively. The increased repair strength using photosealing was statistically significant and considerably higher than the normal intracranial pressure of ~ 20 mmHg. Histology demonstrated a tight union at the interface between the dura surface and patch with no disruption of the dura structure.

Conclusion

The results of this study suggest that photosealing performs better than fibrin glue for the fixation of a patch for ex vivo repair of small dural defects. Photosealing is worthy of testing in pre-clinical models for the repair of dural defects.

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Data Availability

Data from the current original research are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors wish to thank Dr. Michael Marshall, MD, Ph.D., for his assistance in interpreting histology samples.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street, WACC 435, Boston, MA, 02114, USA

    Nicholas C. King & Jonathan M. Winograd

  2. Boston University School of Medicine, Boston, MA, USA

    Nicholas C. King

  3. Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA

    Fernando P. S. Guastaldi

  4. Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA

    Arjun R. Khanna

  5. Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Robert W. Redmond

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  1. Nicholas C. King
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Correspondence to Jonathan M. Winograd.

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King, N.C., Guastaldi, F.P.S., Khanna, A.R. et al. Photosealing of dural defects using a biocompatible patch. Acta Neurochir 165, 2293–2298 (2023). https://doi.org/10.1007/s00701-023-05653-z

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  • DOI: https://doi.org/10.1007/s00701-023-05653-z

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