Brain Tumor Res Treat.  2023 Oct;11(4):232-238. 10.14791/btrt.2023.0021.

A Case Series of DuraMatrix-Onlay^® Plus in Cranial Surgery Is Associated With a Low Complication Profile

• Mekonnen M
• Hovis G
• Mahgerefteh N
• Chandla A
• Malkhasyan Y
• Zhang AB
• Yang I

• KMID: 2547411
• DOI: http://doi.org/10.14791/btrt.2023.0021

Abstract

Background
DuraMatrix-Onlay^® Plus is a collagen dura membrane derived from purified bovine Achilles tendon. The matrix provides a scaffold for collagen synthesis and is intended to be used as an onlay without the need for dural sutures. The study aims to describe our experience with 33 consecutive patients who underwent a duraplasty procedure using the novel DuraMatrix-Onlay^® Plus collagen dura membrane.
Methods
This is a retrospective case series of 33 patients who underwent a duraplasty proce- dure at a single academic hospital in Los Angeles, CA, USA between May 2016 and March 2017. The primary outcome was the incidence rate of cerebrospinal fluid (CSF) leak. Secondary outcomes included rates of patient infection, dural substitute complication, and removal.
Results
Thirty-three patients underwent a duraplasty procedure using the DuraMatrix-Onlay^® Plus material. The average age of the patients was 41.12±7.34 years (range 2–75 years). There were 18 (54.5%) females and 15 (45.5%) males. The majority of procedures were elective operations for the resection of a lesion (n=19, 58%), and the average graft size was 17.69±4.73 cm² . At an average follow-up of 3 months, there were no postoperative CSF leaks. The rates of patient infection, dural substitute complication, and removal were 6%, 6%, and 3%, respectively.
Conclusion
DuraMatrix-Onlay^® Plus is associated with a low rate of postoperative CSF leakage and an acceptable complication profile. This result supports the use of collagen matrices for dural closure in general neurosurgical procedures.

Keyword

Neurosurgery; Dura mater; Graft; Onlay; Brain neoplasms

Figure

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  Fig. 1 A duraplasty technique using DuraMatrix-Onlay® Plus. A: A craniotomy is performed with the appropriate approach according to the indications for the operation. B: The dura is re-approximated as tolerated using running nylon sutures. C: A DuraMatrix-Onlay® Plus matrix is selected according to the size of the defect, then soaked in a solution of antibiotic and saline irrigation. D: The onlay is placed over the dural defect or suture line.

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