Perbandingan jumlah sel mononuklear, jumlah sel fibroblas, ukuran fibrosis, dan perlengketan klinis jaringan peridural pasca prosedur kraniektomi dekompresi dengan dan tanpa proceed surgical mesh pada kelinci new zealand cedera otak traumatik

Introduction: One of the main causes of complications and deaths arising from traumatic brain injury is intracranial hypertension. Therapy to control the increase in intracranial pressure (TIK) is to perform a decompressive craniectomy before definitive treatment. A common problem after decompressive craniectomy is adhesion. The use of proceed surgical mesh as a bioabsorbable membrane is estimated to be able to prevent the occurrence of fibrin bridge formation and adhesion. This study aims to prove the effects of decompressive craniectomy with proceed surgical mesh on mononuclear cells counts, fibroblast cell counts, fibrosis size and clinical adhesions in the peridural of new zealand rabbits with traumatic brain injury. Method: This research uses animal model with randomized post-test only control group design. A total of 20 samples that met the eligibility criteria were included in the study and randomized. A total of 10 samples were grouped as a control group namely the new zealand rabbit group after decompressive craniectomy without proceed surgical mesh and 10 samples the treatment group namely the new zealand rabbit group after decompressive craniectomy with proceed surgical mesh. On day 28, we performed euthanasia and peridural tissue were taken for examination of mononuclear cells counts, fibroblast cell count, and fibrosis size. Mononuclear cells counts, fibroblast cells counts and the size of fibrosis was examined with histopathological techniques. Clinical adhesions is judged by the adhesions between the duramater and the temporalis muscle tissue, fascia or the overlying skin. Hypothesis test using unpaired t test and Mann-Whitney for numerical scale data and Chi Square test for categoric scale data, with significance level p <0,05. Result: From the results of the study it was found that the mean number of mononuclear cell counts was lower in the treatment group (6.7 ± 4.8 cells / LP) than the control group (7.0 ± 3.0 cells / LP). Based on the results of the analysis this difference was not statistically significant (p = 0.481). The mean number of fibroblast cells was lower in the treatment group (15.5 ± 4.1 cells / LP) than in the control group (17.8 ± 5.3 cells / LP). Based on the results of the analysis, this difference was not statistically significant (p = 0.292). The mean fibrosis size showed a significant difference which was lower in the treatment group (549.4 ± 309.1?m) than the control group (830.9 ± 342?m) with p = 0.023. The treatment group by using proceed surgical mesh can significantly prevent 89% of clinical adhesions (p <0.001). Conclusion: Decompressive craniectomy with proceed surgical mesh significantly causes lower fibrosis size and lower risk of clinical adhesions in the peridural new zealand rabbits with traumatic brain injury.