DOI: https://doi.org/10.25305/unj.179831

Cerebrospinal fluid composition after duraplasty with different substitutes in early and late postoperative periods (an experimental study)

Volodymyr O. Pyatikop, Anna V. Kravtsova, Yuliya G. Sergiyenko, Liliya P. Abramova

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.


Keywords


cerebrospinal fluid; dura mater; duraplasty; implant; substitute; chitosan

Full Text:

PDF

References


1. Barrientos S, Leif M, Hon HH, Aizenberg M, Wong S. Duraplasty Using Autologous Fascia Lata and Latissimus Dorsi Free Flap for Chronic Cerebrospinal Fluid Leak. J Craniofac Surg. 2019 Oct;30(7):e671-e674. [CrossRef] [PubMed]

2. McCabe C, Warren R. Trauma: An annotated bibliography of the literature - 2001. Am J Emerg Med. 2002 Jul;20(4):352-66. [CrossRef] [PubMed]

3. Pyatikop VA, Moroz IS, Tarasenko VI, Babalyan YuA, Bibichenko SI, Gunko BV, Genkin AV, Teslenko DS, Masalitin IN. [Cranioplasty of bone defects with differentiated usage of implants]. Ukrainian Neurosurgical Journal. 2011;(3):22-25. Russian. [CrossRef]

4. Lin J, German M, Wong B. Use of copolymer polylactic and polyglycolic acid resorbable plates in repair of orbital floor fractures. Facial Plast Surg. 2014 Oct;30(5):581-6. [CrossRef] [PubMed]

5. Zang G, Yang W, Jiang Y, Zeng T. Extensive duraplasty with autologous graft in decompressive craniectomy and subsequent early cranioplasty for severe head trauma. Chin J Traumatol. 2010 Oct 1;13(5):259-64. [PubMed]

6. Wang C, Liang C, Wang R, Yao X, Guo P, Yuan W, Liu Y, Song Y, Li Z, Xie X. The fabrication of a highly efficient self-healing hydrogel from natural biopolymers loaded with exosomes for the synergistic promotion of severe wound healing. Biomater Sci. 2019 Nov 8. [CrossRef] [PubMed]

7. Guo S, He L, Yang R, Chen B, Xie X, Jiang B, Weidong T, Ding Y. Enhanced effects of electrospun collagen-chitosan nanofiber membranes on guided bone regeneration. J Biomater Sci Polym Ed. 2019 Nov 11:1-14. [CrossRef] [PubMed]

8. Francesko A, Tzanov T. Chitin, chitosan and derivatives for wound healing and tissue engineering. Adv Biochem Eng Biotechnol. 2011;125:1-27. [CrossRef] [PubMed]

9. Jayakumar R, Prabaharan M, Sudheesh Kumar PT, Nair SV, Tamura H. Biomaterials based on chitin and chitosan in wound dressing applications. Biotechnol Adv. 2011 May-Jun;29(3):322-37. [CrossRef] [PubMed]

10. Kaczmarek MB, Struszczyk-Swita K, Li X, Szczęsna-Antczak M, Daroch M. Enzymatic Modifications of Chitin, Chitosan, and Chitooligosaccharides. Front Bioeng Biotechnol. 2019 Sep 27;7:243. [CrossRef] [PubMed] [PubMed Central]

11. Yang TL. Chitin-based materials in tissue engineering: applications in soft tissue and epithelial organ. Int J Mol Sci. 2011;12(3):1936-63. [CrossRef] [PubMed] [PubMed Central]

12. Pogorielov M, Kravtsova A, Reilly GC, Deineka V, Tetteh G, Kalinkevich O, Pogorielova O, Moskalenko R, Tkach G. Experimental evaluation of new chitin-chitosan graft for duraplasty. J Mater Sci Mater Med. 2017 Feb;28(2):34. [CrossRef] [PubMed]

13. Pyatikop VO, Kravtsova AV, Kalinkevich OV, Kalinkevich AN. Structural and biological evaluation of new chitosan membrane for dural closure. Ukrainian Neurosurgical Journal. 2019;25(1):48-55. [CrossRef]

14. Kravanja G, Primožič M, Knez Ž, Leitgeb M. Chitosan-based (Nano)materials for Novel Biomedical Applications. Molecules. 2019 May 21;24(10). pii: E1960. [CrossRef] [PubMed] [PubMed Central]

15. Lippert-Grüner M, Maegele M, Haverkamp H, Klug N, Wedekind C. Health-related quality of life during the first year after severe brain trauma with and without polytrauma. Brain Inj. 2007 May;21(5):451-5. [CrossRef] [PubMed]

16. Carvalho CR, Costa JB, Costa L, Silva-Correia J, Moay ZK, Ng KW, Reis RL, Oliveira JM. Enhanced performance of chitosan/keratin membranes with potential application in peripheral nerve repair. Biomater Sci. 2019 Oct 23. [CrossRef] [PubMed]

17. El-Naggar ME. Synthesis, Drying Process and Medical Application of Polysaccharide-Based Aerogels. Int J Biol Macromol. 2019 Oct 30. pii: S0141-8130(19)37564-6. [CrossRef] [PubMed]

18. Baldrick P. The safety of chitosan as a pharmaceutical excipien. Regul Toxicol Pharmacol. 2010 Apr;56(3):290-9. [CrossRef] [PubMed]

19. Venkataprasanna KS, Prakash J, Vignesh S, Bharath G, Venkatesan M, Banat F, Sahabudeen S, Ramachandran S, Devanand Venkatasubbu G. Fabrication of Chitosan/PVA/GO/CuO patch for potential wound healing application. Int J Biol Macromol. 2019 Oct 14. pii: S0141-8130(19)35397-8. [CrossRef] [PubMed]

20. Dreifke MB, Jayasuriya AA, Jayasuriya AC. Current wound healing procedures and potential care. Mater Sci Eng C Mater Biol Appl. 2015 Mar;48:651-62. [CrossRef] [PubMed] [PubMed Central]

21. Gazzeri R, Neroni M, Alfieri A, Galarza M, Faiola A, Esposito S, Giordano M. Transparent equine collagen biomatrix as dural repair. A prospective clinical study. Acta Neurochir (Wien). 2009 May;151(5):537-43. [CrossRef] [PubMed]


GOST Style Citations






Copyright (c) 2019 Volodymyr O. Pyatikop, Anna V. Kravtsova, Yuliya G. Sergiyenko, Liliya P. Abramova

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.