Dura mater is the connective tissue membrane that surrounds the brain and the spinal cord. Moreover, it must be meticulously closed after craniotomy procedures. In like manner, such closure must prevent any leakage of the cerebrospinal fluid. However, current methods remain unsatisfactory in that respect (Ref).
On the other hand, duraplasty is a common procedure that consists in applying a dural patch or dural substitute. Also, the rationale is to provide a watertight scaffold for endogenous dural repair to proceed flawlessly (neodura formation). Furthermore, current dural substitutes comprise biological grafts, which are difficult to obtain and may expose patients to viral infections or prion diseases and synthetic polymers (Ref, Ref).
In addition, Chitosan-based dural substitutes have been developed and tested in pre-clinical in vivo models (Ref).
Hence, the need for an effective, standardized dural substitute remains.
The opportunity : NovochizolTM-bacterial cellulose dural substitute
Bacterial cellulose is a strong, non-toxic, biocompatible material that can be integrated in the different tissues without causing side effects. Consequently, while pure, bacterial cellulose membranes have been tested as dural substitutes on their own. Additionally, here are several advantages in having bacterial cellulose impregnated with NovochizolTM:
– Chitosan-specific anti-inflammatory properties
– The capacity to encapsulate and retain active ingredients (e.g. vancomycin)
– Higher tensile strength
– Higher flexibility
– Transparency: this unique feature allows to visually inspect underlying tissue for any surgery-related injuries or abnormalities
As a result, in vitro and in vivo investigations have demonstrated the superior features of NovochizolTM– bacterial cellulose dural substitutes:
DM: human cadaveric dura matter, BNC: bacterial cellulose, BNC +N +V: bacterial cellulose impregnated with NovochizolTMand vancomycin. The lines (*) and (**) correspond to data of the same value from of DM (Ref) and Tutopatch® material (Ref)
Reference: Lipovka, A.; Kharchenko, A.; Dubovoy, A.; Filipenko, M.; Stupak, V.; Mayorov, A.; Fomenko, V.; Geydt, P.; Parshin, D. The Effect of Adding Modified Chitosan on the Strength Properties of Bacterial Cellulose for Clinical Applications. Polymers 2021, 13, 1995. https://doi.org/10.3390/polym13121995
