{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T04:58:21Z","timestamp":1785387501050,"version":"3.55.0"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Cir. Bras."],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:p>PURPOSE: The aim of this study was to compare the effectiveness of two dura-mater substitutes, namely human acellular dermal matrix (HADM) and biosynthetic cellulose (BC), in repairing, in utero, surgically-induced meningomyelocele (MMC) in fetal sheep. METHODS: A neural tube defect was created at 74-77 days gestation in 36 fetal sheep. They were divided into 3 groups, the control group that did not receive pre-natal corrective surgery, and the other two groups that received corrective surgery using HADM (Group A) or BC (Group B). Both materials were used as a dura-mater substitutes between the neural tissue and the sutured skin. Correction was performed at gestation day 100 and the fetuses were maintained in utero until term. Sheep were sacrificed on gestation day 140. The fetal spine was submitted to macro and microscopic analysis. At microscopy, adherence of the material to the skin and neural tissue was analyzed. RESULTS: In the initial phase (pilot), experimentally-induced MMC was performed on 11 fetuses and 4 survived (37%). In the second phase (study), 25 fetuses received surgery and 17 survived (68%). In the study group, 6 fetuses did not undergo repair (control group), 11 cases were submitted to corrective surgery (experimental group) and one fetal loss occurred. Of the surviving cases in the experimental group, 4 constituted Group A and 6 in Group B. Macroscopically, skin and underlying tissues where easily displaced from the BC in all cases it was used; in contrast, HADM adhered to these tissues. To compare the adherence, 4 cases from Group A and 4 in Group B were studied. We observed adherence, host cell migration and vessel proliferation into the HADM all sections from Group A and this aspect was not present in any cases in Group B (p &lt; 0.05). In Group B, we also observed that a new fibroblast layer formed around the BC thus protecting the medulla and constituting a \"neoduramater\". CONCLUSION: The use of BC seems to be more adequate as a dura-mater substitute to cover the damaged neural tissue than HADM. It seems promising for use in the in utero correction of MMC because to does not adhere to neural tissue of superficial and deep layers (\"tethered spinal cord\"). Thus, BC minimizes the mechanical and chemical intrauterine damage to the spinal medulla.<\/jats:p>","DOI":"10.1590\/s0102-86502007000300004","type":"journal-article","created":{"date-parts":[[2007,9,27]],"date-time":"2007-09-27T18:57:00Z","timestamp":1190919420000},"page":"174-181","source":"Crossref","is-referenced-by-count":45,"title":["Biosynthetic cellulose induces the formation of a neoduramater following pre-natal correction of meningomyelocele in fetal sheep"],"prefix":"10.1590","volume":"22","author":[{"given":"Rita de C\u00e1ssia Sanchez e","family":"Oliveira","sequence":"first","affiliation":[{"name":"USP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Roberto","family":"Valente","sequence":"additional","affiliation":[{"name":"Dante Pazzanese Institute of Cardiology,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rog\u00e9rio C.","family":"Abou-Jamra","sequence":"additional","affiliation":[{"name":"USP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrezza","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Dante Pazzanese Institute of Cardiology,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Hil\u00e1rio","family":"Saldiva","sequence":"additional","affiliation":[{"name":"USP,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise Ara\u00fajo Lapa","family":"Pedreira","sequence":"additional","affiliation":[{"name":"Albert Einstein Hospital,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1016\/j.ajog.2005.02.110","article-title":"Myelomeningocele: characterization of a surgically induced sheep model and its central nervous system similarities and differences to the human disease","volume":"193","author":"von Koch CS","year":"2005","journal-title":"Am J Obstet Gynecol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9378","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1080\/15513819609169297","article-title":"Acquired spinal cord injury in human foetuses with myelomeningocele","volume":"16","author":"Hutchins GM","year":"1996","journal-title":"Pediatr Patol Lab Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1159\/000065388","article-title":"A different technique to create a 'myelomeningocele-like' defect in the fetal rabbit","volume":"17","author":"Pedreira DAL","year":"2002","journal-title":"Fetal Diagn Ther","ISSN":"https:\/\/id.crossref.org\/issn\/1015-3837","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/0022-3468(95)90335-6","article-title":"Creation of myelomeningocele in utero: a model of functional damage from spinal cord exposure in fetal sheep","volume":"30","author":"Meuli M","year":"1995","journal-title":"J Pediatr Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3468","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/S0022-3468(97)90603-5","article-title":"The spinal cord lesion in human foetuses with myelomeningocele: Implications for fetal surgery","volume":"32","author":"Meuli M","year":"1997","journal-title":"J Pediatr Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3468","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3171\/jns.2005.102.2.0150","article-title":"Adult tethered cord syndrome in patients with post repair myelomeningocele: an evidence-based outcome study","volume":"102","author":"George TM","year":"2005","journal-title":"J Neurosurg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3085","issn-type":"print"},{"issue":"19","key":"ref7","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1001\/jama.282.19.1826","article-title":"Improvement in hindbrain herniation demonstrated by serial fetal MRI following fetal surgery for myelomeningocele","volume":"282","author":"Sutton LN","year":"1999","journal-title":"J Am Med Assoc"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1001\/jama.282.19.1819","article-title":"Fetal surgery for myelomeningocele and the incidence of shunt-dependent hydrocephalus","volume":"282","author":"Bruner JP","year":"1999","journal-title":"J Am Med Assoc"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1159\/000067560","article-title":"The effect of intrauterine myelomeningocele repair on the incidence of shunt-dependent hydrocephalus","volume":"38","author":"Tulipan N","year":"2003","journal-title":"Pediatr Neurosurg","ISSN":"https:\/\/id.crossref.org\/issn\/1016-2291","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1001\/archsurg.138.8.872","article-title":"In utero repair of myelomeningocele","volume":"138","author":"Farmer DL","year":"2003","journal-title":"Arch Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0004-0010","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1097\/00006123-200006000-00020","article-title":"Dural repair using acellular human dermis: experience with 200 cases: technique assessment","volume":"46","author":"Warren WL","year":"2000","journal-title":"Neurosurgery","ISSN":"https:\/\/id.crossref.org\/issn\/0148-396X","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.jpedsurg.2005.10.093","article-title":"The use of human acellular dermis in the operative management of giant omphalocele","volume":"41","author":"Kapfer SA","year":"2006","journal-title":"J Pediatr Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3468","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1067\/mob.2000.108867","article-title":"Hindbrain herniation develops in surgically created myelomeningocele but is absent after repair in fetal lambs","volume":"183","author":"Paek BW","year":"2000","journal-title":"Am J Obstet Gynecol","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9378","issn-type":"print"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"143","DOI":"10.3171\/jns.1997.86.1.0143","article-title":"Duraplasty with biosynthetic cellulose: an experimental study","volume":"86","author":"Mello LR","year":"1997","journal-title":"J Neurosurg","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3085","issn-type":"print"},{"issue":"2-B","key":"ref15","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1590\/S0004-282X2001000300012","article-title":"Uso da cellulose liofilizada em les\u00f5es de nervos perif\u00e9ricos com perda de subst\u00e2ncia","volume":"59","author":"Mello LR","year":"2001","journal-title":"Arq Neuropsiquiatr","ISSN":"https:\/\/id.crossref.org\/issn\/0004-282X","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1159\/000069378","article-title":"Successfull technique to correct a myelomeningocele-like defect in the fetal rabbit","volume":"18","author":"Pedreira DAL","year":"2003","journal-title":"Fetal Diagn Ther","ISSN":"https:\/\/id.crossref.org\/issn\/1015-3837","issn-type":"print"},{"issue":"2","key":"ref17","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1001\/archfaci.2.2.130","article-title":"Evaluation of acellular dermal graft in sheet (AlloDerm) and Injectable (Micronized AlloDerm) forms for soft tissue augmentation: clinical observations and histological analysis","volume":"2","author":"Sclafani AP","year":"2003","journal-title":"Arch Facial Plast Surg"},{"issue":"2","key":"ref18","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1001\/archfaci.3.2.101","article-title":"Evaluation of acellular dermal graft (AlloDerm) sheet for soft tissue augmentation: a 1-year follow-up of clinical observations and histological findings","volume":"3","author":"Sclafani AP","year":"2001","journal-title":"Arch Facial Plast Surg"},{"issue":"4","key":"ref19","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1056\/NEJMoa013325","article-title":"Dermoid inclusion cysts and early spinal cord tethering after fetal surgery for myelomeningocele","volume":"347","author":"Mazzola CA","year":"2002","journal-title":"N Engl Med"},{"issue":"4","key":"ref20","first-page":"251","article-title":"Valida\u00e7\u00e3o do feto de ovino como modelo experimental de meningomielocele: estudo piloto","volume":"4","author":"Pedreira DAL","year":"2006","journal-title":"Einstein"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1097\/01.SAP.0000044252.76804.6B","article-title":"Revascularization of human acellular dermis in full-thickness abdominal wall reconstruction in the rabbit model","volume":"50","author":"Menon NG","year":"2003","journal-title":"Ann Plast Surg","ISSN":"https:\/\/id.crossref.org\/issn\/0148-7043","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1159\/000086808","article-title":"In utero repair of an experimental neural tube defect in a chronic sheep model using biomatrices","volume":"20","author":"Eggkin AJ","year":"2005","journal-title":"Fetal Diagn Ther","ISSN":"https:\/\/id.crossref.org\/issn\/1015-3837","issn-type":"print"}],"container-title":["Acta Cirurgica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/acb\/v22n3\/04.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T14:41:10Z","timestamp":1495723270000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-86502007000300004&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,6]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2007,6]]}},"alternative-id":["S0102-86502007000300004"],"URL":"https:\/\/doi.org\/10.1590\/s0102-86502007000300004","relation":{},"ISSN":["0102-8650"],"issn-type":[{"value":"0102-8650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,6]]}}}