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Results for “Acellular Dermis”

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At least 19 recordsLinked to original sources

PubMed2004

Fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants wrapped with acellular dermis.

PURPOSE: Acellular dermis is a frequently used wrapping material for hydroxyapatite (HA) and porous polyethylene (PP) orbital implants. In an animal model, we determined by histology the extent of fibrovascular ingrowth within orbital implants wrapped in acellular dermis at 6 and 12 weeks after surgery. METHODS: Four Yucatan minipigs were used for the study. Two minipigs had HA implants and two had PP implants. Implants were harvested at 6 or 12 weeks after surgery and were examined histologically for fibrovascular ingrowth. RESULTS: There was complete fibrovascularization of HA implants harvested at both 6 and 12 weeks after surgery. The PP implant harvested at 6 weeks had incomplete fibrovascularization, whereas the PP implant harvested at 12 weeks had complete fibrovascular ingrowth. There was no histologic evidence of inflammation seen in any of the orbital implants. On gross and histologic examination, the wraps were found to persist on the surface of all orbital implants, with little histologic evidence of inflammation localized to the acellular dermis. CONCLUSIONS: Acellular dermis wraps support fibrovascularization of both HA and PP orbital implants. Additionally, acellular dermis does not incite significant inflammation in association with HA and PP orbital implants and can persist in situ for at least 12 weeks after surgery.

Animals↗

PubMedDate not supplied

Acellular dermis for facial soft tissue augmentation: preliminary report.

OBJECTIVE: To evaluate the efficacy of acellular dermis as a viable alternative for soft tissue augmentation in facial reconstruction. DESIGN: A prospective, nonrandomized observational study consisting of 10 patients who underwent soft tissue augmentation with acellular dermis. SETTING: A tertiary care university medical center in an urban setting. PATIENTS: Ten patients who had undergone soft tissue augmentation using acellular dermis participated in this study. Postimplantation follow-up was 17 to 36 months. INTERVENTION: The amount and location for placement of the acellular dermis was left to the discretion of the surgeon. All implants were placed in the subdermal tissues. MAIN OUTCOME MEASURES: The adequacy of acellular dermis for soft tissue augmentation was assessed by subjective evaluation of implant volume persistence, postoperative complications, and the restoration of normal contour. RESULTS: Of 10 patients who underwent implantation, 9 had no complications and 1 had a recurrent sterile abscess or mucocele at the implantation site. A 22-month postimplantation tissue sampling of acellular dermis in a patient with recurrent tumor revealed approximately 80% to 85% volume persistence. CONCLUSION: Preliminary experience with acellular dermis indicates that it shows promise in soft tissue augmentation.

Adult↗

PubMed2003

Graft contraction: a comparison of acellular dermis versus hard palate mucosa in lower eyelid surgery.

PURPOSE: To compare graft contraction rates of acellular dermis versus hard palate mucosa when used as free spacer grafts in lower eyelid surgery and to provide clinical outcome data. METHODS: A prospective, nonrandomized clinical trial involving the placement of 19 spacer grafts in the lower eyelids of 14 patients was performed. Indications for spacer graft placement included lower eyelid retraction and mildly contracted socket. Patients with lower eyelid retraction also underwent an endoscopic subperiosteal midface lift. For all procedures, the height of each graft was measured during and after surgery. The amount of contraction was measured for each graft, and a mean was calculated for each spacer material. The clinical success was evaluated for all procedures, based on improvement of the functional concern being addressed. RESULTS: The mean graft contraction rate was 57% for the acellular dermis and 16% for the hard palate mucosal grafts (P <0.005). Of the 7 procedures using acellular dermis for lower eyelid retraction, 6 were considered a success, and 1 was considered a partial success. Of the 6 procedures using hard palate for lower eyelid retraction, 5 were considered a success, and 1 was considered a failure unrelated to the graft. Of the 5 procedures with acellular dermis used for mildly contracted socket, 2 were considered a success, 2 were considered a partial success, and 1 was considered a failure because of graft contraction. The one case using hard palate for mildly contracted socket was considered a success. CONCLUSIONS: Acellular dermis contracts significantly more than hard palate mucosa when used as a lower eyelid spacer graft. Acellular dermis and hard palate mucosa were both associated with a high rate of clinical success in all categories except for patients with a mildly contracted socket who received acellular dermis; more than 60% of these patients (n=5) had only partial success or failure caused by graft contraction.

Adult↗

PubMed2000

[Clinical use of acellular allogenic dermis or acellular porcine dermis with split-thickness autologous skin graft in 119 cases].

OBJECTIVE: To observe the effect of acellular allogenic dermis or acellular porcine dermis together with split-thickness autologous skin graft on coverage of deep burn wound and the wound of scar excision. METHODS: Acellular allogenic dermis or acellular porcine dermis produced by our unit, with split-thickness autologous skin graft, were used in repairing various wounds in 119 cases. The take rate of various wounds was compared, and the take rate of wounds in which autologous skin from different sites was used to cover either acellular allogenic dermis or acellular porcine dermis was also compared. Histological examination and follow-up were made in some cases. RESULTS: After tangential excision, eschar excision and scar excision, the wounds were covered with either allogenic acellular dermis or porcine acellular dermis and autologous split-thickness skin. The take rate was found to be (93.4 +/- 3.4)%, (92.1 +/- 4.6)%, (94.5 +/- 3.5)%, respectively. There was no a significant difference in take rate (P > 0.05). No significant difference in take rate between the transplantation of allogenic acellular dermis with autologous split-thickness skin and transplantation of porcine acellular dermis with autologous split-thickness skin was found (P > 0.05). When autologous split-thickness skin harvested from the trunk or extremities was used, the take rate was (93.1 +/- 4.8)%, (89.0 +/- 6.2)%, respectively, whereas the take rate was only about 70% - 80% when skin harvested from the scalp was used. The take rate was only about 40% when acellular allogenic dermis and autologous micro-skin graft were used to cover the wound. Histological examination 19 months after the transplantation revealed normal structure. Collagenous fibers were orderly arranged. There was no apparent hyperplasia of collagenous fibers. Hair follicles, sweat glands and other skin appendages were not found in the healed area. Grossly, no obvious pigmentation was seen, the surface was smooth with slight wound contraction, and the consistency was flexible. CONCLUSION: Acellular allogenic split-thickness dermis or acellular porcine split-thickness dermis with autologous split-thickness dermis for coverage of deep burn wound and the wound of scar excision is an ideal material.

Adolescent↗

PubMed2002

[Application of meshed acellular dermis xenograft (pigskin) with scalp thin skin autograft in 15 patients].

OBJECTIVE: To present the clinical application of the meshed acellular dermis xenograft with scalp thin split-thickness skin autograft. METHODS: The meshed acellular dermis xenograft (pigskin) was placed on the granulation or defects after scar resection. Four or five days afterwards, scalp thin split-thickness skin was transplanted. A total of 15 patients with 25 wounds were treated using this technique. The survival rates and quality of the grafts were observed. RESULTS: The survival rate of the meshed acellular dermis xenograft was (96.40 +/- 2.60)% and the scalp thin split-thickness skin autograft was (97.44 +/- 3.50)%. All grafts showed normal skin-alike color and elastic and smooth texture. CONCLUSION: The combined use of meshed acellular dermis xenograft and scalp skin autograft demonstrated an ideal way for the repair of full-thickness skin burn or defects from scar resection. The scalp can provide thin skin graft repeatedly without influence of the hair.

Adolescent↗

PubMed2001

The use of acellular dermis in the prevention of Frey's syndrome.

EDUCATIONAL OBJECTIVE: At the conclusion of this presentation, the participant should be able to discuss the indications and advantages of using acellular dermis in the prevention of post-parotidectomy gustatory sweating (Frey's Syndrome). INTRODUCTION: Gustatory sweating is a common postoperative problem and a challenge to treat. The purpose of this study was to evaluate the role of acellular dermis in preventing post-parotidectomy gustatory sweating. METHODS: Sixty-four patients were randomly assigned to two groups. Group I consisted of 32 patients who underwent a superficial lobe parotidectomy. Group II consisted of 32 patients who underwent a superficial lobe parotidectomy and underwent intraoperative placement of acellular dermis within the parotid bed, between the skin flap and the remaining parotid tissue. The implanted volume of acellular dermis was determined by the amount required to aesthetically restore lateral facial contour. All 64 patients were evaluated for gustatory sweating by identical phone and mail questionnaires. Thirty randomly chosen patients (group I = 15, group II = 15) were evaluated using a modified Minor's Starch-Iodine Test (MSIT). In all 30 patients, the MSIT was administered to both sides of the face. RESULTS: The responses to questionnaires (N = 64) demonstrated the subjective presence of gustatory sweating in 3 of 32 patients (9.3%) in group I, whereas group II demonstrated a subjective incidence in 1 of 32 patients (3.1%). The objective incidence determined by those who underwent the MSIT (n = 30) revealed a 40% (6) and 0% incidence of Frey's Syndrome in groups I and II, respectively. The complication rate in group I was 9% (3 seromas) and in group II it was 25% (7 seromas and 1 wound infection). CONCLUSIONS: Acellular dermis appears to be an effective method for preventing post-parotidectomy gustatory sweating, despite its higher complication rate.

Biocompatible Materials↗

PubMed2003

[Clinical application of meshed porcine acellular dermis xenograft with split-thickness skin autograft].

OBJECTIVE: To observe the clinical effect of meshed porcine acellular dermis xenograft in conjunction with split- thickness skin autograft in the treatment of full-thickness skin burns and the wound after scar resection. METHOD: Sixteen patients receive the treatment with the skin grafts and the effects of one- and two-stage graftings were compared. RESULTS: In the patient group receiving one-stage grafting, 100% survival rate of the grafts was achieved in 4 cases, 95% in 3 cases, and 80% in 1 case. In two-stage grafting group, 100% survival rate of the grafts was achieved in 5 cases and more than 95% in 3 cases. No cases needed secondary grafting. During the follow-up of the patients for 6 months to 2 years, all the grafts assumed basically normal exterior appearance and texture without obvious scar formation. CONCLUSIONS: The combination of meshed porcine acellular dermis xenograft and split-thickness skin autograft was ideal for repairing full-thickness skin burns, for which one- stage grafting is both simple and practical.

Adolescent↗

PubMed2006

Cutometrical measurement confirms the efficacy of the composite skin grafting using allogeneic acellular dermis in burns.

Measurement of viscoelasticity of the skin using the device called cutometer seems to be a very precise and promising diagnostic method in different skin pathologies. However, only a very limited number of reports dealing with the use of cutometer in burns is available. The composite skin grafting using an allogeneic acellular dermis covered with a thin epidermal autologous graft is supposed to improve viscoelastic properties of grafted skin in full-thickness burns. Cutometer MPA 580 has been used for examination of healthy skin, healed and maturated autologous split-thickness skin grafts, and in two patiens 6 years after composite skin grafting using the allogeneic acellular dermis + thin autologous epidermal graft in one stage. Typical curves defined by values of R0-R9 parameters are presented. These data document significantly better viscoelastic properties of composite skin grafts than those of conventional split-thickness skin grafts after 6 years. Measurements of viscoelasticity of the skin, using a cutometer, will probably bring useful and precise data for evaluation of the reconstructed skin in burns. Significantly better properties of the composite skin graft were assessed clinically and measured by Cutometer MPA 580 6 years after surgery.

Adolescent↗

PubMed1996

Evaluation of human skin reconstituted from composite grafts of cultured keratinocytes and human acellular dermis transplanted to athymic mice.

This study evaluates the use of composite grafts of cultured human keratinocytes and de-epidermalized, acellular human dermis to close full-thickness wounds in athymic mice. Grafts were transplanted onto athymic mice and studied up to 8 wk. Graft take was excellent, with no instances of infection or graft loss. By 1 wk, the human keratinocytes had formed a stratified epidermis that was fused with mouse epithelium, and by 8 wk the grafts resembled human skin and could be freely moved over the mouse dorsum. Immunostaining for keratins 10 and 16 and for involucrin revealed an initial pattern of epithelial immaturity, which by 8 wk had normalized to that of mature unwounded epithelium. Mouse fibroblasts began to infiltrate the acellular dermis as early as 1 wk. By 8 wk fibroblasts had completely repopulated the dermis, and blood vessels were evident in the most superficial papillary projections. Dermal elements, such as rete ridges and elastin fibers, which were present in the starting dermis, persisted for the duration of the experiment. Grafts using keratinocytes from dark-skinned donors as opposed to light-skin donors had foci of pigmentation as early as 1 wk that progressed to homogenous pigmentation of the graft by 6 wk. These results indicate that melanocytes that persist in vitro are able to resume normal function in vivo. Our study demonstrates that composite grafts of cultured keratinocytes combined with acellular dermis are a useful approach for the closure of full-thickness wounds.

Animals↗

PubMed2006

A comparison of human and porcine acellularized dermis: interactions with human fibroblasts in vitro.

BACKGROUND: Dermal substitutes derived from xenograft materials require elaborate processing at a considerable cost. Acellularized porcine dermis is a readily available material associated with minimal immunogenicity. The objective of this study was to evaluate acellularized pig dermis as a scaffold for human fibroblasts. METHODS: In vitro methods were used to evaluate fibroblast adherence, proliferation, and migration on pig acellularized dermal matrix. Acellular human dermis was used as a control. RESULTS: Pig acellularized dermal matrix was found to be inferior to human acellularized dermal matrix as a scaffold for human fibroblasts. Significantly more samples of human acellularized dermal matrix (83 percent, n = 24; p < 0.05) demonstrated fibroblast infiltration below the cell-seeded surface than pig acellularized dermal matrix (31 percent, n = 49). Significantly more (p < 0.05) fibroblasts infiltrated below the surface of human acellularized dermal matrix (mean, 1072 +/- 80 cells per section; n = 16 samples) than pig acellularized dermal matrix (mean, 301 +/- 48 cells per section; n = 16 samples). Fibroblasts migrated significantly less (p < 0.05) distance from the cell-seeded pig acellularized dermal matrix surface than in the human acellularized dermal matrix (78.8 percent versus 38.3 percent cells within 150 mum from the surface, respectively; n = 5). Fibroblasts proliferated more rapidly (p < 0.05) on pig acellularized dermal matrix (n = 9) than on the human acellularized dermal matrix (7.4-fold increase in cell number versus 1.8-fold increase, respectively; n = 9 for human acellularized dermal matrix). There was no difference between the two materials with respect to fibroblast adherence (8120 versus 7436 average adherent cells per section, for pig and human acellularized dermal matrix, respectively; n = 20 in each group; p > 0.05). CONCLUSION: Preliminary findings suggest that substantial differences may exist between human fibroblast behavior in cell-matrix interactions of porcine and human acellularized dermis.

Adolescent↗

PubMed2003

Revascularization of human acellular dermis in full-thickness abdominal wall reconstruction in the rabbit model.

This study investigates whether human acellular dermis (Alloderm; LifeCell, Branchburg, NJ) revascularizes when used to reconstruct abdominal wall defects in rabbits. This could prove useful in infected situations in which prosthetic mesh is suboptimal. Twenty-five rabbits were randomly assigned to one of three groups: primary closure (n = 5), expanded polytetrafluoroethylene (GoreTex; W.L. Gore, Flagstaff, AZ) repair (n = 10), or AlloDerm (LifeCell) repair (n = 10). The rabbits in the primary closure group received a 7 cm x 0.5 cm full-thickness abdominal wall defect that was closed primarily. A 7 cm x 3 cm full-thickness abdominal wall defect was created in the other two groups. The defects were repaired with a GoreTex Mycromesh (W.L. Gore), or AlloDerm (LifeCell) patch. At 30 days, the following endpoints were evaluated: (1) incidence of herniation; (2) presence of intra-abdominal adhesions; (3) the breaking strength of the patch-fascial interface; and (4) evaluation of graft vascularization by fluorescein dye infusion and histological analysis. There was no incidence of herniation in any of the rabbits. Visceral adhesions to the patch were found in all animals in the Gore-Tex (W.L. Gore) group but in none in the AlloDerm (LifeCell) group. The size of the patch was unchanged in all the rabbits except for two rabbits in the AlloDerm (LifeCell) group that stretched 1 cm in the transverse dimension. The change in size was not statistically significant (p = 0.17) when compared with the change in size in the Gore-Tex (W.L. Gore) group. The mean breaking strength of the primary closure group was significantly higher (521.2 N/mm2 +/- 223.0) than that of the two patch-repair groups (p < 0.05). But there was no significant difference between the mean breaking strength of the AlloDerm (LifeCell) fascial interface (288.6 N/mm2 +/- 97.1 SD) and that of the Gore-Tex (W.L. Gore) fascial interface (337.0 N/mm2 +/- 141.2). Fluorescein dye infusion and histological analysis confirmed vascularization of the AlloDerm (LifeCell) graft. This study demonstrates that AlloDerm (LifeCell) does become vascularized when used as a fascial interposition graft for abdominal wall reconstruction. AlloDerm (LifeCell) also performs mechanically as effectively as Gore-Tex (W.L. Gore) in ventral hernia repair at 1 month after operation in the rabbit model.

Abdominal Injuries↗

PubMed2000

[The application of meshed acellular dermis xenograft (pigskin) with split thickness skin autograft in 23 patients].

OBJECTIVE: An effective and inexpensive coverage, which can prevent scar formation and fill up scar tissue depression for full thickness skin burns in 23 patients was presented. METHODS: A deepithelized and acellular basement membranes of dermis from freshly harvested pigskin was obtained as meshed acellular dermis xenograft. The patients were treated in one or two stages. Two stages, 7 day postoperative the meshed acellular xenograft, a split thickness skin autograft was applied. One stage, the meshed acellular xenograft and split thickness skin autograft were applied at same time. RESULTS: The take rate of two staged treatment was (87.0 +/- 25.4)% and one stage was (60.3 +/- 3.4)%. All grafts showed in pink or near normal skin color and felt soft and smooth. CONCLUSIONS: The combination of meshed acellular dermis xenograft and split thickness skin autograft demonstrated an ideal way for the coverage of full thickness skin burn, which is effective and inexpensive.

Adolescent↗

PubMed1999

Application of acellular dermis and autograft on burns and scars.

The cases of two patients with burns treated with dermis allograft and of one patient for lip reconstructive aesthetic filling treated with less than one mm3 of radiosterilised acellular dermis are presented. This paper emphasizes the treatment with radiosterilised dermal grafts with a permanent character so far. Hospitals, therefore, can satisfy the demand for this kind of tissue in the case of disaster and patients with serious injuries. In the cases cited, histocompatibility analysis was not required, thus having the advantage of long-time storage of the radiosterilised dermis used on these patients. Neither inflammatory reaction nor acute phase re-absorption were observed. Moreover, shrink (contract) healing was diminished. After two years, the results are still satisfactory.

Adolescent↗

PubMed2000

Human dural replacement with acellular dermis: clinical results and a review of the literature.

BACKGROUND: The search for the ideal dural replacement in the setting where autogenous tissues are unavailable or inadequate still persists. Because of the ability of acellular dermis (AlloDerm, LifeCell Corporation, The Woodlands, TX) to remodel itself into native tissue, this dynamic quality is hypothesized to occur when used as a dural replacement. METHODS: We report the long-term outcome of a small cohort of patients who, to our knowledge, were the first patients to receive AlloDerm for dural replacement. In addition, to put these current findings in a historical perspective, we present a review of the literature for dural replacement. RESULTS: Ten patients all successfully underwent duraplasty with AlloDerm with only one postoperative complication that was not related to the acellular dermal dural repair. CONCLUSIONS: We contend that AlloDerm is a safe and viable option for dural replacement in cases in which autogenous tissues are either unavailable or insufficient for proper reconstruction.

Adult↗

PubMed2006

The use of human acellular dermis in the operative management of giant omphalocele.

PURPOSE: The management of giant omphalocele presents a major challenge to pediatric surgeons. Current treatment modalities often result in wound infection, fascial separation, and abdominal domain loss. Human acellular dermis (AlloDerm), as a primary abdominal fascial substitute, may prevent these complications. We present our experience with its application in neonates with giant omphalocele. METHODS: Charts of patients with giant omphalocele from January 2003 to September 2004 were reviewed and data collected regarding wound healing, rate of infection, ventilatory support, and outcome. RESULTS: Three neonates underwent abdominal wall closure with AlloDerm (gestational ages: 38, 37, and 28 weeks; birthweights 2880, 2640, and 1160 g, respectively). All had cardiac anomalies; 1 required cardiac surgery and 1 was ventilator-dependent, secondary to pulmonary hypoplasia. Omphalocele repair was performed on day-of-life 9, 2, and 87. No fascial dehiscence or infection was encountered. Neovascularization was noted by day 7. Two died of cardiopulmonary disease (6 months and 1 year). The third exhibited normal growth and development without complication. CONCLUSIONS: AlloDerm provides visceral coverage without compromising cardiopulmonary function, diminishing abdominal domain, or requiring multiple operations, allowing prompt treatment of associated anomalies. AlloDerm represents an exciting alternative in the treatment of giant omphalocele. Further study is required to determine long-term benefits.

Collagen↗

PubMed2003

Early one-stage closure in patients with abdominal compartment syndrome: fascial replacement with human acellular dermis and bipedicle flaps.

Decompressive celiotomy for the treatment of abdominal compartment syndrome (ACS) often results in wounds that are difficult to close. These complicated wounds are frequently managed with a 3-staged surgical approach employing a planned ventral hernia. The authors describe an alternative closure with a single operation using a commercially available human acellular dermis (HACD) as a fascial substitute. Soft tissue coverage is obtained at the same operation by means of bilateral bipedicle flaps. The cohort consisted of 9 patients, ages 19 to 77 years old. On average patients were closed on the ninth postoperative day (range, 3 to 30 days) and were discharged from the trauma center on average 8 days (range, 5 to 29 days) after the abdominal closure. Complications developed in 3 (33%) patients. These complications included a flap hematoma, wound infection, and recurrent hernia. There were no postoperative fistulas. This procedure allows for early, single-staged closure of the abdomen after abdominal compartment syndrome. Once closed, patients were able to be discharged from the hospital early and without need for specialized wound care. Further investigation on the usefulness of this technique is required.

Abdominal Muscles↗

PubMed1999

Evaluation of small intestine submucosa and acellular dermis as diaphragmatic prostheses.

BACKGROUND/PURPOSE: The repair of large congenital diaphragmatic defects in the neonate continues to be a challenge. Polytetrafluoroethylene (PTFE) is the synthetic material most widely used for reconstruction in instances of partial and complete diaphragmatic agenesis. Recurrent hernia is a frequent complication, because this material does not grow with the infant. This study evaluates two novel materials; small intestine submucosa (SIS; Cook Biotech, Lafayette, IN), and acellular dermis (AlloDerm; Lifecell Corp, The Woodland, TX) for diaphragm reconstruction in growing animals. METHODS: Sprague-Dawley rats (100 g, n = 87) were anesthetized and underwent laparotomy. The control group (n = 18) underwent a sham laparotomy with a left subcostal incision and closure. The other two groups underwent central excision of the left hemidiaphragm (50% loss) and reconstruction with either a SIS (n = 35) or AlloDerm (n = 19) patch sutured circumferentially with 6-0 prolene. Seventy-two animals survived the operation, and were killed at five separate time intervals (2 weeks, 1, 2, 3, and 4 months). Chest radiographs were performed monthly and before death. Radiographs were reviewed in a blinded fashion by two observers as were the necropsies, and rib deformity was noted if present. Histological examination of the diaphragm patch was performed in each animal. RESULTS: There was no evidence of rib deformity noted on gross examination at necropsy or on chest radiograph in either experimental group. At necropsy, all patches were intact without hernia, eventration, or contraction. Histology findings initially showed acute and chronic inflammatory changes in both patch materials that lessened at the 2-month time interval. Both prosthetic patches began to thin at 3 months and was most prominent in the SIS rats. At 4 months, both SIS and AlloDerm remained viable without evidence of necrosis. Each patch showed evidence of fibroblastic incorporation and small capillary ingrowth. These changes were more prominent in the AlloDerm group. There was no evidence of skeletal muscle ingrowth. CONCLUSIONS: These data indicate SIS and AlloDerm may be useful materials for prosthetic repair in instances of partial or total agenesis of the diaphragm. Further investigation in a large animal model over a longer duration is indicated.

Animals↗

PubMed2001

An animal model of lower eyelid spacer grafting with acellular dermis.

PURPOSE: Lower eyelid retraction is common in patients with dysthyroid orbitopathy and is seen less commonly in other conditions. Treatment typically requires vertical augmentation of the posterior eyelid lamella with an interpositional graft. Several autologous, homologous, and alloplastic materials have been used. We investigated the gross and microscopic in vivo histology of acellular homologous dermis used as a structural interpositional graft in the lower eyelids of Yucatan minipigs. METHODS: This prospective, experimental study was designed as follows: Surgery was performed on the left lower eyelid of 4 Yucatan minipigs in accordance with the Massachusetts General Hospital Subcommittee on Research Animal Care guidelines. A 4 x 20-mm strip of acellular porcine dermis was prepared and sutured into place between the tarsus and conjunctiva/lower lid retractors. Tissues were harvested at 6 and 12 weeks and were evaluated histologically. RESULTS: Gross examination revealed vertical elongation of the palpebral conjunctival surface. Histologic evaluation was performed with hematoxylin and eosin and Verhoeff elastin stains. Serial sections demonstrated incorporation of grafted dermal matrix into native tissues without evidence of inflammation. Definitive differentiation between grafted dermis and native dermis was not possible with light microscopy. Portions of the graft appeared to be epithelialized, whereas other histologic regions showed poorly adhesive epithelium. Inflammatory infiltrates including lymphocytes and polymorphonuclear leukocytes were not seen. No epithelioid or giant cells were identified in the sections examined. CONCLUSIONS: Acellular homologous dermis produced no measurable untoward effects when implanted as an interpositional graft in the lower eyelid of Yucatan minipigs. On the basis of its material characteristics, it appears to be suitable for this purpose: It is readily available, easily stored, easy to manipulate, and produces minimal inflammation. Long-term persistence, early postoperative histology, and clinical eyelid elevation in humans remain to be evaluated.

Animals↗