Incorporation of Integra® in tissue defects: a pilot study in the rat model

Upadhyaya, Manasvi; Orford, Jillian; Smith, Nicholas M.; Barker, Andrew; Gollow, Ian

doi:10.1007/s00383-007-1928-4

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Integra was used for reconstruction of defects created by excision of giant hair nevi, for the reconstruction of acute and chronic wounds, to protect exposed tendons, joints, and bones and to correct volume defects in rhinoplasty. In the rat models there are several studies to assess the feasibility of using this material in other sites: the bladder, the diaphragm, and the abdominal wall [35,36].…”

Section: Discussionmentioning

confidence: 99%

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Hoinoiu

Grujic

Prilipceanu³

et al. 2020

Applied Sciences

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Glycosaminoglycan (GAG) is a chain-like disaccharide that is linked to a polypeptide core to connect two collagen fibrils/fibers and provide the intermolecular force in a Collagen-GAG matrix which can be a valuable treatment of post-burn contractures and hypertrophic scars, which remain a challenge to reconstructive surgery. The face and neck contractures are the most difficult sites to treat. This article is meant to discuss our clinical experience in using collagen-glycosaminoglycan biodegradable matrix (Integra® Integra Lifesciences Corporation, Plainsboro, NJ, USA) to reconstruct defects created by excision of contracted areas from the neck and lower face areas. Between 2009 and 2011, we had 11 patients that underwent Integra reconstructive procedures. The mean follow-up period was 18 months. For all the patients, the intake of the Integra dermal regeneration template was 100%, even if one patient developed a minor infection treated with appropriate antibiotics. The patients are very satisfied with the result. A minor problem was a small difference in skin color, but this inconvenience was compensated by good skin elasticity.

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Section: Discussionmentioning

confidence: 99%

The Use of Collagen-Glycosaminoglycan Biodegradable Matrix (Integra®) in the Management of Neck Postburn Hypertrophic Scars and Contractures

Hoinoiu

Grujic

Prilipceanu³

et al. 2020

Applied Sciences

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“…In the remodelling and maturation phase is observable completion of the matrix degradation and a neosynthesis of collagen by the fibroblasts. Neovascularization in INTEGRA ® has been proved by several studies;[ 41 42 43 ] in this study we aim to prove that an ADM as INTEGRA ® is capable of supporting lymphangiogenesis. Only few studies try to connect wound healing and lymphangiogenesis issues.…”

Section: Discussionmentioning

confidence: 89%

Evaluation of lymphangiogenesis in acellular dermal matrix

Cherubino

Pellegatta

Tamborini

et al. 2014

Indian J Plast Surg

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Introduction:Much attention has been directed towards understanding the phenomena of angiogenesis and lymphangiogenesis in wound healing. Thanks to the manifold dermal substitute available nowadays, wound treatment has improved greatly. Many studies have been published about angiogenesis and cell invasion in INTEGRA®. On the other hand, the development of the lymphatic network in acellular dermal matrix (ADM) is a more obscure matter. In this article, we aim to characterize the different phases of host cell invasion in ADM. Special attention was given to lymphangiogenic aspects.Materials and Methods:Among 57 rats selected to analyse the role of ADM in lymphangiogenesis, we created four groups. We performed an excision procedure on both thighs of these rats: On the left one we did not perform any action except repairing the borders of the wound; while on the right one we used INTEGRA® implant. The excision biopsy was performed at four different times: First group after 7 days, second after 14 days, third after 21 days and fourth after 28 days. For our microscopic evaluation, we used the classical staining technique of haematoxylin and eosin and a semi-quantitative method in order to evaluate cellularity counts. To assess angiogenesis and lymphangiogenesis development we employed PROX-1 Ab and CD31/PECAM for immunohistochemical analysis.Results:We found remarkable wound contraction in defects that healed by secondary intention while minor wound contraction was observed in defects treated with ADM. At day 7, optical microscopy revealed a more plentiful cellularity in the granulation tissue compared with the dermal regeneration matrix. The immunohistochemical process highlighted vascular and lymphatic cells in both groups. After 14 days a high grade of fibrosis was noticeable in the non-treated group. At day 21, both lymphatic and vascular endothelial cells were better developed in the group with a dermal matrix application. At day 28, lymphatic endothelial cells had organized themselves, engineering the pseudocylindrical structure better disposed in the ADM group than in the control group, and the lymphatic cells were detectable inside the vessels’ lumen in this group.Conclusion:This study has made it possible to demonstrate the absolute importance of an ADM in proper wound healing and has shown better definition of both the qualitative and quantitative aspects of lymphangiogenesis compared to the second intention healing. A major grade of organization of the extracellular matrix and a minor grade of fibrosclerosis in ADM allowed a well-structured morphologic and functional development of the endothelial and lymphatic vascular structures. This study hopes to represent a clinical basis for a wider use of ADM in lesions where lymphatic complications are common.

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