DURASHEET vs DECOLL: Helping a Surgeon Pick the Right DESU Membrane

DURASHEET and DECOLL are both DESU collagen dura membranes made from pure Type I bovine collagen, supplied in four sizes, ready to use and gamma sterilized. The practical difference is technique. DURASHEET is usable on both surfaces and suturable; DECOLL is designed for onlay use. The surgeon’s preferred closure method is usually the quickest guide.

Distributors and reps are often asked a simple question in the OR or at a department meeting: “Which of your two grafts should I use?” This article gives a clear, accurate way to answer it, without overstating what either product does.

What do DURASHEET and DECOLL have in common?

Both products start from the same material and the same manufacturing philosophy. That shared foundation matters, because it means the choice between them is not a trade-off in material quality. It is a choice about how the graft will be placed.

• Material: pure Type I bovine collagen, processed in DESU’s own cleanrooms in Ankara, Türkiye.
• Range: four sizes for each product.
• Format: ready to use, with preparation according to the instructions for use.
• Sterility: gamma sterilized.
• Quality system: manufactured under ISO 13485 and CE marked.

For background on how bovine collagen is sourced and controlled, see our article on bovine collagen safety in dural grafts.

How are they different?

The two rows that differ are the ones a surgeon cares about most. DURASHEET is described as a dural graft matrix that can be sutured and can be used on either surface, which removes the need to check orientation before placement. DECOLL is described as suitable for onlay use, where the membrane is laid over the defect and overlaps the surrounding dura.

When does DURASHEET make more sense?

DURASHEET is the natural first suggestion when the surgeon intends to fix the graft to the dural edge with sutures. Typical situations include:

• Surgeons whose standard practice is a sutured duraplasty, whatever the case.
• Defects where the surgeon wants the graft held in position before closing the overlying layers.
• Cases where the surgeon wants the option to suture or not, decided once the defect is exposed.
• Teams that value not having to identify an upper or lower surface under the microscope.

Being usable on both surfaces is a small practical advantage that scrub teams often appreciate. It simplifies handing the graft to the surgeon and reduces a decision point during a step that is already demanding.

Flexibility is the other argument. A surgeon who is unsure, before opening, whether a defect will need a sutured patch or a simple overlap can open DURASHEET and decide once the dura is exposed. For departments that want a single default graft for mixed case types, that versatility is often the deciding factor, and it keeps the number of products on the shelf to a minimum.

When does DECOLL make more sense?

DECOLL is the natural first suggestion when the surgeon prefers an onlay technique. Onlay grafts are widely used in cranial and spinal surgery, sometimes alone and sometimes over a primary suture line or alongside a sealant, according to the surgeon’s judgment. Situations where DECOLL often leads the conversation include:

• Surgeons who routinely lay a graft over the dural opening rather than suturing it.
• Reinforcement over a primary repair, where the graft is not intended to bear sutures.
• Limited exposures where suturing a patch is difficult and the surgeon prefers an overlap technique.

A dedicated onlay product also sends a clear signal to the OR team. When a surgeon’s preference card lists DECOLL, the scrub nurse knows the plan is an overlap technique, and the instruments and adjuncts can be prepared accordingly. That clarity is useful in departments where several surgeons share the same rooms and staff.

The surgeon remains responsible for deciding whether an onlay is appropriate for the defect in front of them. Our article on non-suture onlay techniques covers the general principles.

What questions help a surgeon choose?

A rep does not need to make the clinical decision. A few neutral questions usually make the answer obvious to the surgeon.

• Do you usually suture your graft, lay it on, or decide case by case?
• Do you want one graft that can do both, or a dedicated onlay product?
• Which procedures in your practice involve a duraplasty most often?
• How large are the defects you typically repair, and which sizes do you open most?

A surgeon who answers “I always suture” points to DURASHEET. A surgeon who answers “I almost always onlay” points to DECOLL. A surgeon who answers “it depends” may prefer DURASHEET as a flexible default, or both products stocked side by side.

It helps to ask these questions before the first case rather than in the OR. A short conversation in the surgeon’s office, followed by an update to the preference card, means the right product and size are already in the room on the day. Reps who arrive with both products and no plan tend to leave the decision to the busiest moment of the case.

It is also worth asking the scrub team. Nurses and surgical technologists who prepare grafts every week can tell a rep which surgeons trim heavily, which ones ask for a larger size “just in case” and which ones change technique depending on the procedure. That information shapes the size mix as much as the product choice.

Should a hospital stock both?

Stocking both is common in departments where several surgeons work with different techniques. Because each product has only four sizes, carrying both does not create an unmanageable item list. It does need a little discipline: clear labeling on the shelf, a simple guide for scrub staff and a par level for each size based on real use.

Where storage space or budget is tight, a hospital may start with one product matched to its highest-volume surgeons and add the second later. A distributor can support that by reviewing usage after the first few months and recommending adjustments.

A note for distributors

Presenting the pair as a matched system tends to be more persuasive than presenting two separate products. The message is simple and honest: one material, one manufacturer, one quality system, two placement options. It also makes it easier for a value analysis committee to add the line as a whole.

It also simplifies documentation. Because both products share the same material, manufacturer and quality system, much of the supporting paperwork a hospital requests, such as quality certificates and information on animal-origin controls, applies to both. A distributor can assemble one packet for the pair and add the product-specific instructions for use.

What should the rep avoid saying?

Neither product is promoted as producing a watertight seal on its own, preventing CSF leaks or replacing the surgeon’s own closure technique. Keep comparisons to the documented features and let the instructions for use define indications, preparation and placement. If a surgeon asks something the documents do not answer, the right response is to ask DESU directly.

Talk to a DESU product specialist

If you would like help presenting DURASHEET and DECOLL to a neurosurgery or spine team, or want samples and documentation for an evaluation, DESU’s product specialists can support you. Write to sales@desu.tr, use the contact page, or request a quote for your account.