Large retrospective study of artificial dura substitute in patients with traumatic brain injury undergo decompressive craniectomy.

Background: Decompressive craniectomy is widely used for treating patients with traumatic brain injury (TBI). Usually patients have dura mater defect due to surgery or injury itself. The defective area may left open or repaired by artificial dura substitutes. A variety of artificial dura substitutes have been used for this purpose.

Objective: This study aimed to evaluate bovine-derived pericardium membrane as artificial dural material for patients with decompressive craniectomy.

Methods: Totally 387 patients with severe TBI in our hospital were included in this study. Among them, 192 patients were treated with standard decompressive craniectomy without dura repair (control group). One hundred and ninety-five TBI patients were treated with dura repair by artificial dura materials (ADM). Nonlyophilized bovine pericardium membranes were used as artificial dura material. The postoperative complications were compared in both groups, including infection, seizure, and cerebrospinal fluid (CSF) leakage.

Results: Patients in control group have higher complication rates than patients in ADM group, including subcutaneous hematoma (13.02% in control vs. 4.01% in ADM group,  = .004), infection (12.5% in control vs. 5.64% in ADM group,  = .021), CSF leakage (13.02% in control vs. 5.13% in ADM group,  = .012), and seizure (10.42% in control vs. 3.08% in ADM group,  = .007). Patients in ADM group are only associated with higher incidence of foreign body reaction (6 of 195 patients in ADM vs. none from control group).

Conclusion: Bovine-derived pericardium membranes are successfully used as artificial dural substitutes for decompressive craniectomy. Patients with ADM have better clinical outcome than control group.