Abstract
Purpose: :
To provide an in vivo experimental model comparing porcine acellular implant (Enduragen) and human acellular dermal implant (Alloderm) when used as a spacer graft in lower eyelid surgery. We sought to compare the resorption and fibrovascular ingrowth of these two graft materials.
Methods: :
A prospective, nonrandomized clinical study was performed in which surgical placement of either a graft of Enduragen or an equally sized graft of Alloderm was placed into the lower eyelids of ten New Zealand White rabbits. All implants measured 10 mm by 15 mm and approximately 1 mm in thickness. The eyelids were examined clinically and histologically at three and six months postoperatively.
Results: :
At three months Alloderm demonstrated moderate amount of peripheral and central vascularization (n=4), and Enduragen demonstrated mild peripheral vascularization (n=4). At six months, Alloderm showed a mild to moderate vascularization (n=6) with high rate of resorption limiting the extent of vascularization measurements. Five out of six Enduragen grafts showed mild peripheral vascularization and one Enduragen graft showed moderate diffuse vascularization.At three months all of the Alloderm grafts were still present: height average 4.79 mm by width average 1.38. Conversely, at three months the average measurements of Enduragen grafts remaining were 5.38 mm height by 1.16 mm width, with one graft extrusion. At six months, three Alloderm grafts had indistinguishable margins due to complete host integration. Average measurements of Alloderm grafts remaining were 1.89 mm height by 0.60 mm width. Of the Enduragen grafts at six months, five of the six grafts remained. The remaining average measurements were 4.35 mm height by 1.04 width.
Conclusions: :
At 3 and 6 month intervals, Enduragen demonstrated less graft resorption and fibrovascular ingrowth when compared to Alloderm in this rabbit model. Further investigation with a larger subject pool would be beneficial.
Keywords: anatomy • wound healing • eyelid