Table 3.
Summarized data of the synthetic polymeric dural substitutes with their advantages, limitations, study type, no. of subjects, mechanical properties, and anti-CSF leakage properties.
| Type of Dural substitute | Advantages | Limitations | Type of study | No. of subjects | Ultimate tensile strength (MPa) | Young’s modulus (MPa) | CSF leakage | References |
|---|---|---|---|---|---|---|---|---|
| Triple-layered PCL dural substitute | Mimics the extra cellular matrix of the native dura mater, prevents infections, and promotes tissue regeneration | NA | In vitro study | NA | 22.42 ± 0.89 | NA | NA | Su et al. 36 |
| Urethane linked PCL dural substitute | Effective integration with native dura mater and does not produce any inflammation or adhesion to surrounding tissues | NA | In vitro and in vivo study (rats) | NA | NA | NA | Not observed | Shih et al. 37 |
| PLLA patch | Good mechanical properties, no inflammation reaction and appropriate rate of degradation | NA | In vivo study (dogs) and clinical study | 24 dogs and 1 patient | 4.14 ± 0.18 | NA | Not observed | Shi et al. 16 |
| PGA mesh (GM111) | No inflammatory reaction and wound infection | NA | Clinical study | 60 | NA | NA | Not observed | Terasaka et al. 38 |
| PGA mesh | Effective in dural closure | Short follow-up time | Retrospective study | 75 | NA | NA | Observed in one patient | Masuda et al. 39 |
| PGA mesh | NA | Foreign body granuloma was observed | Case report | 1 | NA | NA | NA | Kawabata et al. 40 |
| Dural sealant patch | Effective in dural closure and preventing CSF leakage | One case of serious adverse event was reported | Clinical study | 40 | NA | NA | Not observed | Van Doormaal et al. 41 |
| Neuro-patch | No incidence of infection seen | NA | Clinical study | 103 | NA | NA | Not observed | Li et al. 42 |
| Neuro-patch | NA | Raised risk of wound infection | Retrospective study | 61 | NA | NA | 13% | Malliti et al. 43 |