Collagen-only biomatrix as dural substitute: What happened after a 5-year observational follow-up study

Objectives: To assess long-term efficacy of the collagen-only biomatrix as a dural substitute in a large case series. Patients and methods: We reviewed a prospectively acquired database of patients who underwent neurosurgical surgeries in whom the dural substitute was used and who were the subject of two previous studied with shorter follow-ups. Results: The present study was conducted on 111 subjects of the original 209 patients. No late complications, nor local or systemic toxicity were observed during the observational period. As a matter of facts, 5 patients (4.5%) underwent reoperation for different reasons and 2 out of 5 experienced subcutaneous fluid collections; another case (0.9%), already reported in our previous studies, developed a CSF leak after an endoscopic endonasal operation for an intra-suprasellar arachnoid cyst. Conclusions: Our data further confirm that the collagen-only biomatrix derived from horse equine tendon is a safe and effective dural substitute for routine neurosurgical procedures.