Background: Intracranial infection is one of the most common complications of open craniocerebral injury and of conventional craniotomy in neurosurgery. The presence of blood-brain barrier leads to lower drug concentrations in the cerebrospinal fluid than in the venous blood. Increasing the intravenous dosage or frequency carries the risk of systemic adverse reactions or infections in other parts of the body. Developing an artificial dura mater (ADM) for sustained antibiotic release for use during neurosurgery can solve the problems perfectly.
Methods: Three types of drug-loaded ADMs made of collagen and containing cefuroxime sodium, ceftriaxone sodium, or norvancomycin were prepared. The antibacterial activity and sustained release characteristics of the ADMs were examined using bacteriostatic and release tests.
Results: Single-layered collagen based ADMs (40 mm×50 mm×5 mm) containing 18 mg cefuroxime sodium or ceftriaxone sodium were not suitable for continued development because of drug preservation and stability issues. Using smaller ADMs (20 mm×30 mm×7 mm), containing 4.86 mg of norvancomycin, with increased collagen density and a three-layered film with two outer drug-free films above and below the antibiotic layer resulted in sustained cumulative release of 2.91 mg (59.9%) of norvancomycin over 72 hours. The similar factor (f2) comparison method proved that products from a same batch were statistically significant similar (f2 > 50).
Conclusions: Artificial ADMs made of collagen can be processed to provide a mature dural repair material for the sustained release of norvancomycin. This system may provide a basis for developing sustained release materials for other drugs.