title: Pig dorsum model for examining impaired wound healing at the skin-implant interface of percutaneous devices.
abstract: Percutaneous medical devices are indispensable in contemporary clinical practice, but the associated incidence of low to moderate mortality infections represents a significant economic and personal cost to patients and healthcare providers. Percutaneous osseointegrated prosthetics also suffer from a similar risk of infection, limiting their clinical acceptance and usage in patients with limb loss. We hypothesized that transepidermal water loss (TEWL) management at the skin-implant interface may improve and maintain a stable skin-to-implant interface. In this study, skin reactions in a 3-month, pig dorsum model were assessed using standard histology, immunohistochemistry, and quantitative image analysis. Immunohistochemical analysis of peri-implant tissue explants showed evidence of: continuous healing (cytokeratin 6+), hypergranulation tissue (procollagen+), hyper-vascularity (collagen 4+), and the presence of fibrocytes (CD45+ and procollagen type 1+). Importantly, the gross skin response was correlated to a previous load-bearing percutaneous osseointegrated prosthetic sheep study conducted in our lab. The skin responses of the two models indicated a potentially shared mechanism of wound healing behavior at the skin-implant interface. Although TEWL management did not reduce skin migration at the skin-implant interface, the correlation of qualitative and quantitative measures validated the pig dorsum model as a high-throughput platform for translational science based percutaneous interface investigations in the future.
authors.affiliation: Bone and Joint Research Laboratory, DVA SLC HCS, 500 Foothill Drive, 151F, Salt Lake City, UT 84148, USA.
authors.forename: Brian Mueller
authors.initials: BM
authors.lastname: Holt
authors.forename: Daniel Holod
authors.initials: DH
authors.lastname: Betz
authors.forename: Taylor Ann
authors.initials: TA
authors.lastname: Ford
authors.forename: James Peter
authors.initials: JP
authors.lastname: Beck
authors.forename: Roy Drake
authors.initials: RD
authors.lastname: Bloebaum
authors.forename: Sujee
authors.initials: S
authors.lastname: Jeyapalina
mesh_terms: D000818:Animals; D001834:Body Water; D008954:Models, Biological; D019736:Prostheses and Implants; D013552:Swine; D013556:Swine, Miniature; D014945:Wound Healing