In neurosurgery neural defects are a common problem, many etiologies compromise dura mater integrity. These scenarios had demonstrated the need for a dural substitute. Multiple substitutes had been proposed: autografts, allografts, xenografts and synthetic materials. None of them fulfill all the "ideal substitute" enquiries. The hypothesis of this paper is supported by previous work of Tomohisa et al. And Campbell et al. Tomohisa et al presented 12 cases were synthetic substitutes had infected tissue and the need of removal was inevitable. Fortunately, the capsule was protecting brain parenchyma, and the absence of CSFL give them the option of closing with no further duroplasty. They suggest that in these scenarios where infection prevents the option any graft, the preexisting capsule works as an appropriate substitute. In the other paper, a new vascular graft was presented, where sylastic tube were placed in rabbits and mice, then harvested after two weeks and used the capsule of granulation tissue as an autologous vascular graft. This autologous substitute could work as an adequate scaffold for graft integration in dura mater.
Marco Aurelio Rendón Medina