Lyophilised dura mater: experimental implantation and extended clinical neurosurgical use.

The historical development of dural substitutes and the process of regeneration of dura mater are reviewed. Lyophilised human cadaver dura mater has been implanted intracranially in baboons and the graft shown to be incorporated with vascularisation but with ossification. In the human, lyophilised dura mater used as a dural substitute also becomes a viable tissue but without ossification. A retrospective study of its use in 100 neurosurgical patients showed a low complication rate and it is suggested that there are occasions when the ready availability of lyophilised dura mater, without the need for a further incision, makes it the dural substitute of choice.