Acellular porcine intestinal submucosa as fascial graft in an animal model: applications for revision tympanoplasty.
OBJECTIVE
To demonstrate regeneration of muscle fascia appropriate for future harvest with the use of acellular porcine intestinal submucosa in a rat model.


METHODS
Animal cohort study.


METHODS
Tertiary care academic medical center.


METHODS
Sixteen male Sprague-Dawley rats underwent excision of rectus abdominis muscle fascia. A sheet of acellular porcine intestinal submucosa was placed in the fascia harvest defect. Graft and underlying muscle were harvested at three-, six-, and nine-week intervals. Histologic examination, including immunohistology for anti-von Willebrand factor, was performed at each timepoint. Additional selected specimens were subjected to latex vascular perfusion casts to examine vessel growth patterns within the graft.


RESULTS
Gross examination revealed a new tissue plane, indistinguishable from surrounding native fascia. Histology revealed an initial inflammatory response within the graft. Progressive influx of native tissue was noted over successive timepoints. Via collagen-specific staining, we noted progressive reorganization and maturation of the graft collagen matrix. At the final nine-week time point, a new loose connective tissue plane was reestablished between the graft and underlying muscle. Immunohistochemistry and latex perfusion both demonstrate an initial development of small capillaries that progresses over time to greater organization and arteriole formation.


CONCLUSIONS
Fascia regeneration may be possible with use of an acellular porcine intestinal submucosa graft in an animal model. Future studies may prove beneficial in restoring fascia in humans. Implications for potential advantages in tympanoplasty are discussed.
Ort
Stuart A
SA
California Ear Institute, East Palo Alto, CA, USA. sort@calear.com
Ehrlich
H Paul
HP
Isaacson
Jon E
JE
D000818:Animals; D005205:Fascia / Q000473:pathology / Q000503:physiopathology; D000071938:Fasciotomy; D007413:Intestinal Mucosa / Q000637:transplantation*; D008297:Male; D023421:Models, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D017568:Rectus Abdominis / Q000601:surgery; D013552:Swine; D016378:Tissue Transplantation / Q000379:methods*; D014433:Tympanoplasty / Q000379:methods*; D014945:Wound Healing