History and prospects of dura mater substitute materials

JIANG Xiaobing; LIU Hanyuan

doi:10.13798/j.issn.1009-153X.2025.10.013

Abstract：The dura mater serves as a critical barrier protecting the central nervous system,and its repair is essential for preventing serious complications such as cerebrospinal fluid leakage,intracranial infection,and cerebral adhesion.This arti-cle systematically reviews the evolution of dura mater substitute materials since 1893.The development process can be divided into three main stages:first,the early exploration phase(circa 1890-1940),where the clinical goal was primarily to prevent post-traumatic epilepsy-related meningeal adhesions,with attempts including metal foils,autologous tissues(such as fascia lata),and early synthetic materials;second,the standardized development phase(circa 1940-1980),which focused on achieving watertight closure to prevent cerebrospinal fluid leakage in addition to preventing adhesions,leading to the widespread research and application of non-absorbable synthetic materials(such as polyethylene and ePTFE)and absorbable natural materials(such as collagen and lyophilized human dura mater);third,the bioengineering and composite materials phase(circa 1980-present),driven by the"Lyodura incident,"where material safety became the primary concern,shifting research emphasis toward ani-mal-derived decellularized matrices with better biocompatibility and tissue regeneration guidance,functionally modified com-mercialized collagen,and composite materials combining the advantages of both.In the future,the development of dura mater substitutes will shift from pursuing"universal"materials to precise and multifunctional designs tailored to specific clinical sce-narios,potentially integrating with technologies such as cranial repair and biological adhesives to meet the evolving demands of minimally invasive and refined neurosurgery.