Laboratory studyThe biocompatibility of BioGlue with the cerebral cortex: a pilot study
Introduction
A watertight closure of the dura to prevent cerebrospinal fluid (CSF) leakage is a critical component of most intracranial and intradural spinal procedures. It is frequently difficult to obtain a direct primary closure of the dura, and often a dural graft is necessary in order to obtain satisfactory closure. Tissue glues, such as BioGlue® Surgical Adhesive (BioGlue, CryoLife, Inc., Kennesaw, GA), have been reported as aiding in dural closure, either by reinforcing a primary closure of the dura or sealing the edges of the graft.[1], [2]
In using a dural sealant, there is a concern as to its toxicity, if it inadvertently leaks onto the underlying cerebral cortex. Even though biologically based sealants comprised of fibrin or gelatin have had some success in certain surgical disciplines[3], [4], [5] including application to the cranium, soft tissue of the cranial base, paranasal sinuses, subdural and epidural spaces,[6], [7], [8] side effects such as neurotoxicity, induction of oedema or seizures, intense inflammation of vessels and possible arterial occlusions have been reported.[9], [10], [11]
In this study, we have investigated the effect of BioGlue, a surgical adhesive that is comprised of bovine serum albumin (BSA) and glutaraldehyde (GA) on rat cerebral cortex.
Section snippets
Materials and methods
Twenty-three adult wistar rats (200–250 g) were sedated using penthrane inhalation and then anaesthetized using an intraperitoneal administration of xylene (8 mg/kg)/ketamine (44 mg/kg). The scalp was incised, reflected and a dental drill used to perform a craniotomy measuring approximately 6 mm × 6 mm anterior to the coronal suture over the left cerebral hemisphere.
A fine nerve hook was used to lift the dura at the posterior end of the craniotomy while a microsurgical knife and scissors were
Results
No adverse reactions, deaths or seizure activity were noted in any of the animals.
Discussion
BioGlue is an adhesive which is a combination of BSA and GA in the ratio of 45% and 10%, respectively. BSA possesses lysine groups which contain amine groups that can be linked by the aldehyde groups in glutaraldehyde. The GA acts as a connector molecule by binding the lysine groups of the BSA as well as those present in the extracellular matrix and cell surface allowing the BSA to bind to tissue. The high concentration of BSA present in BioGlue coupled with the rapid reaction between aldehydes
Conclusions
The 2-week pilot study on the biocompatibility of BioGlue with rat cerebral cortex tissue can be summarized by the following points: all rats tolerated the surgical procedures well, remained in excellent general health throughout their post-operative course, were neurologically intact throughout the study and no seizures were noted; BioGlue applied directly to the exposed surface of the normal brain parenchyma may result in a minimal inflammatory response that is seen only on the surface of the
Acknowledgements
This study was supported by a grant from CryoLife Inc. (Kennesaw, GA, USA).
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