4 0 monocryl suture

Skin was incised on a 3 cm straight line from the nasal bone to the midsagittal crest. Periosteum was elevated to allow exposure of the parietal bone. Two bone defects (10 mm) on each side of the midline were created with a trephine bur under irrigation with sterile saline. Care was taken to avoid injury of the dura. A drilling procedure with a trephine bur was done very carefully with low speed (maximum 800 rpm) by trained cranio-maxillofacial surgeons. Drilling was stopped before reaching the dura and the bone pieces were removed by blunt instruments such as mucosa elevators. Under the conditions of the experiment, fresh blood needed to be mixed with the biomaterial under investigation. Blood was therefore sampled from the catheterized auricular artery approximately half way through the procedure (arterial blood gases were analysed at the same time). Following mixture, the biomaterials were implanted directly into the bone defects. After implantation the periosteum and skin were closed with interrupted sutures in layers using 4–0 Vicryl and 4-0 Monocryl sutures (Ethicon, Somerville, NJ, USA). The wound surface was further protected with spray film dressing (Opsite^® spray, Smith & Nephew, London, UK).

The skin of the head was incised from the nasal bone to the mid-sagittal crest, and the parietal bone was exposed after the periosteum elevation. Two critical-sized (10 mm diameter) bone defects were prepared in the parietal bones with a trephine drill, with maximal care not to injure the dura mater. Both CM biomaterials were pre-shaped with a scalpel into 10 mm diameter and 3 mm thickness cylinder (Figure 2A), and implanted in the defects without excessive pressure (Figure 2B). The applied treatment modalities, (1) empty control (n = 6), (2) Ncl_CM (n = 8), and (3) Cl_CM (n = 8), were randomly allocated. The wound was sutured in two layers using 4–0 Vicryl^® (Ethicon, Somerville, NJ, USA) and 4–0 Monocryl^® sutures (Ethicon). Furthermore, the surfaces of the wound were covered with a spray film dressing (OPSITE^® SPRAY, Smith & Nephew, London, UK).