Abstract: Mechanical pressure on dural or fascial wound edges exerted by cerebrospinal fluid (CSF) is thought to impair proper apposition of the wound borders and therefore prevent healing. Interestingly, it has been observed that the surgical tissues exposed to CSF do not bleed,
exhibit smooth edges, and have no evidence of granulation tissue formation. This raises the question of whether the constituents of CSF
themselves impair normal wound healing. However, the biochemical interaction of CSF with the healing process has not been
investigated. Here, we hypothesize that CSF exhibits anti-angiogenic properties and therefore inhibits the healing process.
Conclusions: CSF inhibited cord formation with a dose-dependent tendency, implying that it contains signaling molecules that preclude angiogenesis. This effect was cell specific and not observed
with fibroblasts. These experiments suggest that CSF, rather than acting as an inert bystander, may actively impair healing by inhibiting
capillary formation.
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