Integra Acellular Collagen as a Vascular Carrier for Skin Flap Prefabrication in Rats

Abstract

In this study, the feasibility of Integra acellular collagen used as a vascular carrier in skin flap prefabrication was examined. In all, 20 Sprague--Dawley rats were randomly divided into 3 groups. The saphenous vascular bundle was used as the vascular carrier. In group 1 (n = 8), an arteriovenous fistula was made by anastomosis of distal saphenous artery and vein. An Integra patch (2 × 3 cm²) was placed underneath the vascular bundle. In group 2 (n = 6), an Integra patch was placed on the top of the saphenous vessels, which remained intact. In group 3 (n = 6), an arteriovenous fistula was made without Integra implant. Two weeks after the initial management, a skin flap (2 × 3 cm² in size) was raised and replaced in each group. The survival of the flaps and histology were evaluated at 7 days after flap replacement. The results showed that the average survival area in group 1 was 98% ± 2%. No flap survival was observed in group 2. The mean survival area in group 3 was 29% ± 6%. The differences among all 3 groups were significant (P < 0.05). Although the mean survival area in group 3 was significantly lower than that in group 1 (P < 0.001), it was significantly higher than that in group 2. Histology showed that the Integra patch was incorporated into the adjacent connective tissue, and increased amounts of neovascularization were seen between the collagenous sheets and dermis in group 1. In conclusion, this study demonstrated that Integra acellular collagen can incorporate into the adjacent tissue as a vascular carrier and induce angiogenesis in flap prefabrication. This biomaterial can provide a scaffold for supporting and enhancing the survival of a vascular prefabricated skin flap. The results indicate that this material is an ideal biomaterial for flap prefabrication and may be used for this clinical purpose in the future.

Tissue and Organ Regeneration in Adults

“…Studies have shown that angiogenesis initially appeared in DRT at day 7 following grafting, and peaked between day 7 and 14 (Shaterian et al 2009); DRT was found capable of active neovascularization and capable of serving as an effective dermal substitute (DS) in avascular wounds (Baynosa et al 2009); also DRT induced angiogenesis in flap prefabrication, and therefore could be used to support vascularization survival of a vascular prefabricated skin flap (Yan et al 2011).…”

The Use of Urinary Bladder Matrix in the Treatment of Trauma and Combat Casualty Wound Care

“…Blast injuries create diffuse areas of soft tissue destruction along with bacterial impregnation into wounds that directly correlate with increase rates of infection [36]. The large areas of uncovered defects in the soft tissue only serve to increase rates of infection.…”

“…There are multiple clinical applications and many anatomical sites that benefit from treatment with biologic scaffolds. Biologic scaffolds have been shown to facilitate limited tissue remodeling in a number of tissues in both preclinical animal models and human clinical studies [26][27][28][29][30][31][32][33][34][35][36][37][38][39]. The host response to biologic scaffold has been extensively characterized.…”