Duraplasty with pretreated freeze-dried sterilized human dura mater.
Different collagenic tissues, such as allogeneic fascia lata, dura mater and xenogeneic pericardium preserved by deep freezing or freeze-drying and packed in National Blood Service jars have been used with good clinical results in duraplasties performed at the Department of Neurosurgery, University Hospital at Hradec Králové since 1956. In 1986 a new technology of preservation of the human dura mater was elaborated by the Tissue Bank at Hradec Králové. The implant is pretreated, freeze-dried, wrapped in two plastic bags or Steriking see-through peel-packs (Wipak Medical, Finnland) and sterilized by gamma radiation or ethylene oxide gas. Its advantages are in simple storage in operating rooms and in opportunity to choose an ideal graft with regard to its shape, size and plasticity. No rehydration is needed before the clinical use. The total of 30 grafts in 30 patients (15 children and 15 adults) have been implanted successfully since 1987. Most duraplasties were performed in the posterior cranial fossa and on the brain convexity. In these situations an intradurally burying of the graft edges and atraumatic continuous suture is recommended.