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Use Of Porcine Acellular Dermal Matrix As Resurfacing Graft To Promote Angiogenesis And Epithelialization Of Avascular Wounds
Hamid R. Zahiri DO, Gilbert Lahoud MD, Alexandra Conde'-Greene MD, Ronald P. Silverman MD, Luther Holton MD, Jeffrey A. Stromberg MD, Devinder P. Singh MD
University of Maryland School of Medicine
2012-01-29
Presenter: Dr. Hamid Zahiri
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
The above work has been performed by Dr. Hamid Reza Zahiri.
Director Name: Stephen Kavic, MD
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
How does this presentation meet the established conference educational objectives?
This work represents new clinical science research, techniques, and procedures relevant to plastic and reconstructive surgery.
How will your presentation be used by practicing physicians in the audience?
Our data is preliminary, but shows new wound healing techniques, for avascular wounds, that may significantly improve healing and reduce wound complications and scarring.
Introduction
Angiogenesis and epithelialization restore the epidermis after injury. We investigated epithelialization of porcine acellular dermal matrix (PADM) as resurfacing graft for avascular wounds.
Methods
Forty full-thickness 4x4 cm wounds were created paraspinally on the dorsum of 5 Yorkshire pigs. For experimental wounds, 1x1 cm or 2x2 cm silastic sheets were sutured to centeral regions of experimental wounds prior to resurfacing with PADM. Positive controls had no silastic sheets and negative controls had 4x4cm silastic sheets under PADM. Derssings were negative pressure vs. bolster. After 21 days, central and lateral regions of each wound was biopsied. Immunohistochemistry with hematoxylin & eosin (H&E) and Factor VIII stains revealed angiogenesis per sample. These were counted using light and compared using unpaired t-test and one-way analysis of variance with Newman-Keuls multiple comparison posttest. Significance was p value ≤ .05.
Results
After 21 days, epithelialization was grossly evident peripherally and centrally for 1x1cm avascular and positive control wounds. 2x2cm avascular wounds exhibited peripheral epithelialization more than central regions of PADM. Histological analysis revealed significantly more blood vessels per mm2 for 1x1cm wounds compared to 4x4cm negative controls (25.4 vs. 13.9, p < 0.05). No significant difference in angiogenesis was present between 1x1cm versus 2x2cm wounds (25.4 vs. 19.6, p > 0.05) or positive controls (25.4 vs. 30.1, p > 0.05). Negative pressure dressing increased angiogenesis compared to bolster dressing (25.4 vs. 20.7), although not significantly (p > 0.05).
Summary
PADM may prove beneficial in promotion of healing in avascular wounds caused by diabetes, vascular disease, trauma, or debilitation.
