Evaluation of acellular dermal graft (AlloDerm) sheet for soft tissue augmentation: a 1-year follow-up of clinical observations and histological findings.
OBJECTIVE
To evaluate and compare the long-term clinical persistence and histological appearance of subdermally implanted acellular dermal graft (AlloDerm) sheets and intradermal type I bovine collagen cross-linked with glutaraldehyde (Zyplast).


METHODS
Ten adult patients (5 men and 5 women; average age, 46 years; age range, 37-59 years) not allergic to bovine collagen.


METHODS
AlloDerm sheets were implanted surgically in a subdermal plane in one postauricular crease, and Zyplast was injected intradermally on the opposite side. AlloDerm and Zyplast implants were digitally photographed and their apparent volumes calculated at 1, 3, 6, 9, and 12 months after implantation. A specimen was removed at 3 and 12 months and examined histologically for collagen persistence, host tissue invasion, and inflammatory reaction.


RESULTS
The apparent implant volume of the AlloDerm sheets decreased during the first 6 months and then stabilized over the next 6 months. By contrast, Zyplast was progressively absorbed, with complete loss of clinical effect by 6 months. Histological analysis of implanted AlloDerm sheets demonstrated progressive repopulation of the graft with minimal inflammation.


CONCLUSIONS
AlloDerm sheets seem to provide stable soft tissue augmentation after an early period of resorption and are clearly superior to Zyplast injections for long-term, large-volume, soft tissue correction. Recommendations for clinical use include routine overcorrection, with subsequent augmentation delayed by at least 6 months.
Sclafani
A P
AP
Division of Facial Plastic Surgery, The New York Eye and Ear Infirmary, 310 E 14th St, North Bldg, Sixth Floor, New York, NY 10003, USA. asclafani@nyee.edu
Romo
T
T
Jacono
A A
AA
McCormick
S A
SA
Cocker
R
R
Parker
A
A
D000328:Adult; D001672:Biocompatible Materials; D003094:Collagen / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods; D017768:Skin, Artificial
D001672:Biocompatible Materials; C048470:glutaraldehyde-cross-linked collagen; D003094:Collagen