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Integration of Biologic Matrices in Wounds with Avascular Structures
Vanessa Mroueh, MD; Fuat Baris Bengur, MD; Chiaki Komatsu, MD; Benjamin K. Schilling, PhD; Yadira Villalvazo, MD; Pooja Humar, MD; Mario Solari, MD
University of Pittsburgh
2025-01-16
Presenter: Vanessa Mroueh, MD
Affidavit:
100% of the work represents the original work of the post-doctoral fellow, Vanessa Mroueh.
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 compares matrices with conventional tissue transfer in wounds with poorly-vascularized structures. We aim to evaluate the ability of three commercially-available biologics from different sources to integrate over avascular structure and their viability compared to skin-grafts and 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, free-flap, bovine tendon collagen/glycosaminoglycan(Integra), porcine urinary bladder matrix(Cytal), or acellularized human skin(Alloderm) 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/IF.
Results
Wound sizes were constant throughout the experiment. Necrosis occurred in skin grafts and dermal matrices overlying the silicone, with exposed silicone at 4-week endpoint. Integra and Cytal had higher percent of exposed silicone surface-area (mean viable percent over silicone=8.2% and 15.4%, respectively) than skin-graft(93%) and free-flap(100%)(p<0.05). Alloderm showed intact integrity but no viability over the silicone sheet(0%). Histology showed no vascularity of all matrices over the silicone sheet, except at silicone edges.
Conclusion
Biological wound matrices did not survive over the avascular structure as compared to free-flaps and skin-grafts. 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.
