This disclosure describes a membrane configured to guide bone and tissue regeneration for a bone defect. The membrane may comprise a first layer, a second layer, one or more perforations, a binder, and/or other components. The first layer of the membrane may be configured to contact bone. The first layer may include pores configured to promote ingrowth of bone regenerating cells into the first layer. In some implementations, the first layer may be a continuous sheet of microporous material without large perforations. The second layer may be configured to substantially prevent fibrous connective tissue from growing into the bone defect. The second layer may comprise a relatively dense structure. The second layer may be fixedly coupled to the first layer. In some implementations, the perforations may comprise co-axial through-holes having common dimensions through the first layer and the second layer. The perforations may be configured to enhance ossification.