A new type of bilayer dural substitute candidate made up of modified chitin and bacterial cellulose

In the field of neurosurgery, timely and effective repair of dura mater plays an important role in stabilizing the physiological functions of the human body. Therefore, the aim of this study is to develop a new type of bilayer membrane as a dural substitute candidate. It consists of a dense layer that prevents cerebrospinal fluid leakage and a porous layer that promotes tissue regeneration. The dense layer, a composite polysaccharid film, was composed of high molecular weight chitosan (CS) and bacterial cellulose (BC). The porous layer, a composite polysaccharid scaffold cross-linked by glutaraldehyde (GA) or citric acid (CA) respectively, was composed of O-carboxymethyl chitin (O-CMCH) and BC. The bilayer dural substitutes were characterized in terms of SEM, mechanical behavior, swelling rate, anti-leakage test, in vitro cytotoxicity, proliferation, and animal experiment. Results indicated that all prepared dural substitutes were tightly bound between layers without excessively large cavities. The porous layer showed appropriate pore size (90～200 μm) with high porous connectivity. The optimized bilayer dural substitutes showed suitable swelling rate and mechanical behavior. Furthermore, no leakage was observed during testing, no cytotoxicity effect on NIH/3T3 cells, and exhibited excellent cell proliferation promoting properties. Also, it was observed that it did not deform in the peritoneal environment of mice, and tissue inflammation was mild.