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Small molecule delivery into acellular dermal matrix (ADM) by vacuum infiltration

I. Nick Vial, Isaac James, Kacey Marra, J. Peter Rubin, Carolyn De La Cruz
University of Pittsburgh Medical Center, Deptartment of Plastic Surgery
2015-03-15

Presenter: I. Nick Vial

Affidavit:
This represents original work by the authors and has not been previously presented at any national meetings or previously published.

Director Name: Joseph Losee

Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction

BACKGROUND
Acellular dermal matrix (ADM) is a decellularized, biologic, dermal allograft with applications throughout plastic surgery, including breast, hernia and cleft palate reconstruction. As an allograft with minimal immunogenicity, it also holds potential as a delivery vehicle for small molecules, such as chemotherapeutics, antibiotics, and gene therapy. This study sought to investigate methods available to surgeons at the point of care.
METHODS
127 mg/mL methylene blue (MB) was infiltrated into Alloderm RTU. Groups included: 2min MB soak (manufacturer's recommendation), 20min MB soak, 2min MB vacuum at 90kPa, and saline soak. To simulate transudate encountered by ADM in vivo, treated ADM disks were soaked in 10mL of fresh saline, replaced daily for 14d. MB release was calculated by spectroscopy of wash fluid, while retention was assessed by color densiometry.
RESULTS
Vacuumed disks demonstrated color intensity 30-fold higher than either soaking group through day 14 (p<0.001). Compared to 2min soak control, MB release was 2.6 (p<0.001) and 1.9 (p=0.027) times higher in the vacuum group at days 1 and 2 respectively but equalized thereafter. Compared to 2min soak, 20min MB soak had 1.5x more color retention up to day 12 (p=0.048) and greater release at days 1 (1.5x, p=0.010), 2 (1.9x, p<0.001), and 3 (1.5x, p=0.010).
CONCLUSIONS
Vacuum prolonged dye retention and initial release compared to both 2min and 20min soak. 20min soak also prolonged dye retention up to 12d and enhanced dye release up to 3d. The success of these delivery methods merits further investigation with antibiotics and other small molecules.

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