Porcine small intestine graft for reconstruction of oral defects

Abstract

Objective: To evaluate the feasibility and outcomes of porcine submucosal allograft (Biodesign Sinonasal Repair Graft [Cook Medical, Bloomington, IN]) in oral cavity and oropharynx reconstruction after ablative surgery. Methods:We conducted a prospective and retrospective review of patients who underwent Biodesign Sinonasal Repair Graft reconstruction for oral and oropharyngeal surgical defects at a single institution between 2018 and 2020. A total of 11 patients were included in the study. Data points included their perioperative medical and demographic data, immediate postoperative course, and follow-up visits at 10 days and at 2 months. The clinicopathologic characteristics of their disease, postoperative esthetic, and functional outcomes were recorded and analyzed.Results: Eleven procedures have been performed, and all patients received Biodesign reconstruction either immediately after ablation or after they failed a previous reconstruction. None of the patients had bone exposure. The subsites included oral tongue (n = 6), floor of the mouth (n = 3), buccal mucosa (n = 1), and soft palate (n = 1). In all cases, the operations and the postoperative course were uneventful. The mean defect size was 22 cm 2 . The median start of oral intake was at 2 days postoperatively. The Biodesign graft healed well in all patients with no total graft loss. There was one complication that required revision surgery due to obstruction of Wharton's duct by the Biodesign material.Conclusions: Biodesign can be a viable option for small and medium-sized oral and oropharyngeal defects in patients who are medically unfit or do not want to undergo a free flap surgery.

Extracellular matrix scaffold-assisted tumor vaccines induce tumor regression and long-term immune memory

“…Decellularized porcine small intestinal submucosa (SIS) ECM was prepared for use as an archetypical ECM scaffold biomaterial and cryogenically milled into an injectable particulate ( Fig 1A ). SIS was selected because it has been extensively studied in soft tissue repair in both pre-clinical and clinical models, including in cancer treatment [7, 8, 25, 26]. An injectable formulation permits minimally invasive localized delivery and avoids the trauma of surgical implantation thus isolating the host response to the ECM scaffold itself ( Fig 1B ).…”

“…Decellularized porcine small intestinal submucosa (SIS) ECM was prepared for use as an archetypical ECM scaffold biomaterial and cryogenically milled into an injectable particulate (Fig 1A). SIS was selected because it has been extensively studied in soft tissue repair in both preclinical and clinical models, including in cancer treatment [7,8,25,26]. An injectable formulation permits minimally invasive localized delivery and avoids the trauma of surgical implantation thus Tumor antigen uptake is the first step of generating cytotoxic cellular immunity during cancer vaccination, and since previous studies showed that leukocytes readily infiltrated ECM scaffold biomaterials [10,11,13,27], we sought to determine if these cells were capable of internalizing exogenous vaccine antigen.…”

“…Extracellular matrix (ECM) scaffolds are medical devices derived from decellularized mammalian tissues that are increasingly used biomaterials in cancer care, where they are implanted in patients during reconstructive surgeries immediately following tumor resection [4][5][6][7][8]. ECM scaffolds are immunomodulatory but generate an immune environment that is entirely distinct from the foreign body reaction generated by many synthetic, polymeric scaffold materials.…”

Advances in oral tongue reconstruction: a reconstructive paradigm and review of functional outcomes

“…Case reports have reported the feasibility of substitutes including acellular dermal homograft, bilayer wound matrix, and porcine submucosal grafts. However, there remains limited evidence on the objective benefits of these reconstructive alternatives [5 ▪ ,6,7].…”