An experimental study and case analysis of acellular dermal matrix implantation for restoration of soft tissue defects

Ryu, Sun Youl; Ryu, Jae Young

Abstract

PURPOSE: This study was aimed to examine the resorption rate, the healing pattern, and the response of the surrounding tissue after the graft of the acellular dermal matrix (AlloDerm(R)) and the autogenous dermis, and to report the clinical result of the use of AlloDerm(R) in order to restore the soft tissue defects.
METHODS
Twenty mature rabbits, weighing about 3 kg, were used for the experimental study. The 10x10 mm-size autogenous dermis and the AlloDerm(R) were grafted to the space between the external abdominal oblique muscle and the fascia of the rabbits. And the AlloDerm(R) was grafted to the pocket between the skin and the underlying perichondrium of rabbit ear. The resorption rate of the grafted sites was calculated, and the tissue specimens were histologically examined at 1, 2, 4, and 8 weeks after the graft. The five patients with the cleft-lip nasal deformity and the one patient with the saddle nose deformity, who received the AlloDerm(R) graft to restore the facial soft tissue defects, were reviewed for the clinical study.
RESULTS
The resorption rate at 8 weeks after the graft was 21.5percent for the autogenous dermis, and 16.0percent AlloDerm(R). In microscopic examinations, the infiltration of the inflammatory cells and the epidermal inclusion cyst were observed in the autogenous dermis graft. However, the neovascularization and the progressive growth of the new fibroblasts were shown in the AlloDerm(R) graft. And the six patients, who received the AlloDerm(R) graft, demonstrated the good stability of the grafts and improved appearance. There were no remarkable complications such as inflammation, rejection, dislocation, and severe absorption in the clinical cases.
CONCLUSION
These results suggest that AlloDerm(R) can be an useful graft material for restoration of soft tissue defects because of the good stability and the tissue response without the remarkable clinical complications.