Preliminary ex vivo and in vivo evaluation of laser bonding in dura mater

摘要

Dura mater repair represents a final and crucial step in cranial surgery: an inadequate dural reconstruction determinesdreadful consequences that significantly increase morbidity and mortality rates. Different dural substitutes have been usedwith poor results. To overcome this issue, in previous studies we proposed a laser-based approach to the bonding of porcinedura mater, evidencing the feasibility of the laser assisted procedure. In this work, we present the optimization of the laserbonding approach ex vivo in porcine dura mater and in vivo in rats. An 810 nm cw laser was used to weld the ICG stainedchitosan patch to the dura. The ex vivo tests enabled to optimize the laser parameters, using histology and leak pressureevaluation to study the bonding effect. The in vivo tests were performed on 32 adult Wistar rats: laser bonding was carriedout in 16 rats, while a collagen matrix was used for duroplasty in the control group. After the treatment, the animals wereleft to recover and were observed in a 15 and 90 days follow up study. At sacrifice, the rats were anesthetized for fluidleakage pressure test; treated tissue was harvested and underwent standard histology. The results of this study pointed outthat the laser bonding procedure can be used to close the dura mater, both ex vivo and in vivo. The thermal effect is limitedand spatially confined. The technique can thus be proposed as a valid alternative to standard method for the closuring ofdura mater in cranial surgery.