Dehydrated Human Dura Mater Patch Repair for Closure of Duodenal Defects

Authors: M. Faik ÖZÇELİK, Salih PEKMEZCİ, Suha GÖKSEL, Mesut NEGİZADE, Ediz ALTINLI, Yılmaz ERSAN

Abstract: The suitability of dehydrated human dura mater patch on the repair of full thickness duodenal wall tissue loss is investigated, the healing process is followed. In 28 Spraque Dawley rats, approximately 3 mm in diameter defects were made laterally to the second duodenal portion by excision. These defects were repaired using a dehydrated human dura mater patch. The rats were sacrificed at the 3rd, 7th, 14th and 21 st days and wound healing was evaluated histopathologically. Three rats died post-operatively. Two two of them died after 24 hours with possible acute panceratitis. The other rat which died later on had duodenal obstruction at the patched area. 0n the 21st day, the defects were covered by duodenal mucosa macroscopically. According to histopathological evaluation, no surface epithelium nor mucosal regenanation existed at the 3rd and 7th days. 0n the 14th day, surface epithelium regeneration was partial, yet no mucosal restoration was observed. More than 25% of the dural patches were replaced by newly formed collagen fibers at the 7th and 14th days. 0n the 21st day, surface epethelial regeneration was complete and the mucosal reconstruction was partial. Cryptic restoration was nearly complete, villous formation had started, and the newly formed collagen leaflets hat almost completely replaced the dura patch.

Keywords: Duodenal defect, dura mater, patch, repair.