<< Back to the abstract archive
Wound Healing Over Non-Vascularized Structures with Biologic Wound Matrices
Vanessa Mroueh, MD; Fuat Baris Bengur, MD; Chiaki Komatsu, MD; Benjamin K. Schilling, PhD; Mario G. Solari, MD
University of Pittsburgh
2024-01-15
Presenter: Vanessa Mroueh, MD
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.
Director Name: Peter Rubin
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background
Soft tissue defects with exposed critical structures usually require reconstruction with well-vascularized tissues. Given their lack of blood supply and dependence on nutrients from wound bed, biologic wound matrices may not be reliable. Limited data exist comparing matrices with conventional tissue transfer in wounds with poorly-vascularized structures. We aim to evaluate healing patterns in different biological matrices and assess where their wound healing capabilities fall within the spectrum of complete necrosis (with skin-grafts) to complete healing (with free-flaps).
Methods
Full-thickness wounds were created on Lewis rats and a silicone sheet was secured to the wound bed. A custom-made-3D-printed wound contraction frame was placed around the wound. Split-thickness skin-graft, or free-flap, or bovine tendon collagen/glycosaminoglycan (Integra) or porcine urinary bladder matrix (Cytal) were used to cover the defects. Rats were followed for 4 weeks with weekly photography. Samples were retrieved at endpoint for histology with H&E/Trichrome.
Results
Wound sizes were constant throughout the experiment's duration. Necrosis of portion of skin-graft and dermal matrix that corresponds to silicone sheet was observed with exposure of silicone sheet at 4-week endpoint. Integra and Cytal had higher percent of exposed silicone surface-area than skin-grafting and free-flap(p<0.05). Free-flaps provided complete coverage over silicone sheet.
Conclusion
Biological wound matrices did not achieve complete wound healing over the avascular structure as compared to free-flaps and did not even reach the durability of skin grafting. Our model allows us to further test survival of matrices under different controlled-conditions like closed-wet-wound design, or with adjunctive therapies like cell therapy.
