Histopathological analysis of duragen collagen matrix over time in humans

Abstract DuraGen is a widely used type I collagen matrix derived from bovine Achilles tendon that promotes fibroblast ingrowth and neovascularization. However, it remains unknown the time required for dura regeneration and reabsorption of the graft. We evaluate the histopathological characteristics...

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Main Authors: Takuma Maeda, Kaima Suzuki, Peyton L. Nisson, Yoshiki Mochizuki, Reina Mizuno, Akio Teranishi, Yushiro Take, Tomomichi Kayahara, Hiroki Kurita
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-95489-7
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author Takuma Maeda
Kaima Suzuki
Peyton L. Nisson
Yoshiki Mochizuki
Reina Mizuno
Akio Teranishi
Yushiro Take
Tomomichi Kayahara
Hiroki Kurita
author_facet Takuma Maeda
Kaima Suzuki
Peyton L. Nisson
Yoshiki Mochizuki
Reina Mizuno
Akio Teranishi
Yushiro Take
Tomomichi Kayahara
Hiroki Kurita
author_sort Takuma Maeda
collection DOAJ
description Abstract DuraGen is a widely used type I collagen matrix derived from bovine Achilles tendon that promotes fibroblast ingrowth and neovascularization. However, it remains unknown the time required for dura regeneration and reabsorption of the graft. We evaluate the histopathological characteristics of implanted DuraGen in humans across multiple time points. Patients who underwent a decompressive craniectomy and duraplasty with DuraGen at our institution between January 2020 and September 2021 were prospectively enrolled. At the time of the subsequent surgery, including cranioplasty, DuraGen and associated tissues removed from patients were sent for histopathological analysis. For each patient, time from index surgery to subsequent surgery was categorized into three groups: early (0–20 days), intermediate (21–30 days), and late (> 30 days). Baseline characteristics, primary disease, operative time, complication rate, and histopathological findings were compared between groups. A total of 28 patients were enrolled in the study. Seven specimens (25.0%) were collected within 20 days after craniectomy, 9 specimens (35.7%) between 21 and 30 days, and 12 specimens (39.3%) over 31 days. Histopathologically, implanted collagen matrix, erythrocyte infiltration, and fibrin layer decreased over time, whereas fibroblasts and endogenous collagen increased. Receiver operating characteristic analysis showed that the cut-off time post-implantation for presence of endogenous collagen was 34 days after DuraGen implantation (area under the curve = 0.810). We found that DuraGen was replaced by fibroblast-derived endogenous collagen as early as 34 days post-implantation. Although certain findings remain to be further validated, the present study substantiates DuraGen as a reliable substitute, with findings derived from clinical outcomes and histopathological changes.
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spelling doaj-art-9af9ebaee4ee4d558e55c7e0fa4919a02025-08-20T03:07:40ZengNature PortfolioScientific Reports2045-23222025-04-011511910.1038/s41598-025-95489-7Histopathological analysis of duragen collagen matrix over time in humansTakuma Maeda0Kaima Suzuki1Peyton L. Nisson2Yoshiki Mochizuki3Reina Mizuno4Akio Teranishi5Yushiro Take6Tomomichi Kayahara7Hiroki Kurita8Department of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterBarrow Aneurysm and AVM Research Center, Barrow Neurological InstituteDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterDepartment of Cerebrovascular Surgery, Saitama Medical University International Medical CenterAbstract DuraGen is a widely used type I collagen matrix derived from bovine Achilles tendon that promotes fibroblast ingrowth and neovascularization. However, it remains unknown the time required for dura regeneration and reabsorption of the graft. We evaluate the histopathological characteristics of implanted DuraGen in humans across multiple time points. Patients who underwent a decompressive craniectomy and duraplasty with DuraGen at our institution between January 2020 and September 2021 were prospectively enrolled. At the time of the subsequent surgery, including cranioplasty, DuraGen and associated tissues removed from patients were sent for histopathological analysis. For each patient, time from index surgery to subsequent surgery was categorized into three groups: early (0–20 days), intermediate (21–30 days), and late (> 30 days). Baseline characteristics, primary disease, operative time, complication rate, and histopathological findings were compared between groups. A total of 28 patients were enrolled in the study. Seven specimens (25.0%) were collected within 20 days after craniectomy, 9 specimens (35.7%) between 21 and 30 days, and 12 specimens (39.3%) over 31 days. Histopathologically, implanted collagen matrix, erythrocyte infiltration, and fibrin layer decreased over time, whereas fibroblasts and endogenous collagen increased. Receiver operating characteristic analysis showed that the cut-off time post-implantation for presence of endogenous collagen was 34 days after DuraGen implantation (area under the curve = 0.810). We found that DuraGen was replaced by fibroblast-derived endogenous collagen as early as 34 days post-implantation. Although certain findings remain to be further validated, the present study substantiates DuraGen as a reliable substitute, with findings derived from clinical outcomes and histopathological changes.https://doi.org/10.1038/s41598-025-95489-7Collagen matrixCranioplastyDuraGenDural regenerationEndogenous collagenFibroblast
spellingShingle Takuma Maeda
Kaima Suzuki
Peyton L. Nisson
Yoshiki Mochizuki
Reina Mizuno
Akio Teranishi
Yushiro Take
Tomomichi Kayahara
Hiroki Kurita
Histopathological analysis of duragen collagen matrix over time in humans
Scientific Reports
Collagen matrix
Cranioplasty
DuraGen
Dural regeneration
Endogenous collagen
Fibroblast
title Histopathological analysis of duragen collagen matrix over time in humans
title_full Histopathological analysis of duragen collagen matrix over time in humans
title_fullStr Histopathological analysis of duragen collagen matrix over time in humans
title_full_unstemmed Histopathological analysis of duragen collagen matrix over time in humans
title_short Histopathological analysis of duragen collagen matrix over time in humans
title_sort histopathological analysis of duragen collagen matrix over time in humans
topic Collagen matrix
Cranioplasty
DuraGen
Dural regeneration
Endogenous collagen
Fibroblast
url https://doi.org/10.1038/s41598-025-95489-7
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