Use Of Spongostan To Prevent Cranial Subdural Fibrosis In A Craniotomy Rabbit Model

Introduction:Spongostan(Absorbable Haemostatic Gelatin Sponge) is a sterile, water-insoluble, malleable, porcine gelatin absorbable sponge intended for haemostatic use by applying to a bleeding surface. The sponge is off-white and porous in appearance.

Material and Method :This study was performed in accordance with guidelines from the ethics committee at the University of Hacettepe School of Medicine. 18 domestic albino rabbits (4,5 kg mean weight) were used in this study. The animals were randomized into two groups before surgery as: Group 1, Spongostan patch group; Group 2, Control group. After intramuscular anesthesia induction with Ketamine (50 mg/kg), all rabbits were placed at prone position and curvilinear incision was made at the right frontoparietal region. Oval bone flap was performed with a Midas Rex craniotome (Medtronic, Fort Worth, TX). C type incision was used for dural opening. After the incision; The appropriate material was delicately implanted under the dura mater defects for group 1. and the dura mater sectioning was performed without haemostatic material implantation for group2. All surgical wounds were closed with appropriate suturing.

Results :All of the animals were sacrified 90 days after duratomy. Dural healing was seen in both of the groups. Paraffin-embedded sections were sent for histopathologic examination. In spongostan used animals, there was no fibrosis under the area of the dural incision. In control animals, the dura was irregularly thickened, up to 2 mm, by mature fibrous tissue.

Conclusions :Subdural fibrozis is an important problem after craniotomy and it makes difficult to re-operations. Spongostan is a sterile, water-insoluble, malleable, porcine gelatin absorbable sponge material and reduce subdural fibrozis significantly. We belive that it’s useful in reducing the complications of cranial re-operations.