Duraplasty with Autologous Blood: A Cost-Effective and Efficient Alternative to Medical Products

Abstract

Objective The aim of this experimental study was to investigate the effects of autologous plasma used as an alternative to duraplasty. Materials and Methods We operated 21 patients and 8 New Zealand Rabbits and performed duraplasty with autologous blood. First, heparin was added to autologous blood withdrawn from the patient/rabbit. The sample was then centrifuged to obtain plasma. Protamine sulfate was added to the plasma. This mixture was then applied to the dural space and tumor cavity, resulting in fibrin formation within 2 to 3 minutes. All 21 patients had magnetic resonance imaging (MRI) scans 1 month after surgery to show neodura formation. Three of our patients and all rabbits were operated at least a month later, and the biopsy was taken to show the neodura formation microsopically. Results In MRI scans, as well as in biopsies, we have detected the neodura formation. In rabbits that underwent experimental craniotomy and duratomy, neodura had formed as a weak, thin membrane that did not show continuity into the defect area after one month. In the control group, the distribution of collagen fibers appeared relatively normal in areas close to the intact dura. However, further from this area, the regular structure was disrupted, edematous areas had formed in the fibrous layers, and bone fragments were separated from the endosteal layer Conclusion The hypothesis of this study was that plasma obtained from the patient's own arterial blood could serve as an alternative to traditional duraplasty materials. Plasma possesses many of the properties required for duraplasty material and can be a cost-effective, readily available option. Results demonstrate that autologous plasma does not induce significant histological changes and shows excellent biocompatibility with brain parenchyma. Therefore, autologous plasma can be considered a reliable and safe tissue sealant. It is easy to prepare and apply, remains stable in the operating room for 1 to 2 hours, and can be adjusted in size and thickness according to the dural defect and tumor cavity dimensions.