The Biomechanical Properties Of Meshed Versus Perforated Acellular Dermal Matrices: Analysis Of Surface Area And Fluid Egress
Katherine H. Carruthers, M.D., M.S.1, Pankaj Tiwari, M.D.2, Ergun Kocak, M.D., M.S.2.
1West Virginia University, Morgantown, WV, USA, 2Midwest Breast & Aesthetic Surgery, Gahanna, OH, USA.
Acellular dermal matrices (ADMs) are used for soft tissue augmentation across surgical specialties. Since allograft incorporation is dependent on direct opposition between the ADM and a vascular bed, the presence of seromas can inhibit this process. As a result, most ADM products are available in a variety of meshed or perforated forms. Because of the lack of consistency between manufacture designs, we set out to determine the fluid egress properties and the increase in surface area resulting from common cut patterns.
Three ADM cut patterns were studied: one meshed and two perforated. The surface area of these modified ADM samples was calculated, accounting for the mesh length or the perforation diameter and frequency. Fluid was passed through each ADM and the amount of time required for fluid passage was recorded. An ANOVA was used to determine if there was a significant difference in egress properties across the three patterns. A p-value of <0.05 was used to determine statistical significance.
Meshing in a 1:1 pattern resulted in a 97.50% increase in surface area compared to the uncut product. In comparison, only a 0.30% increase resulted from Perforation Pattern #1 and a 0.59% increase resulted from Perforation Pattern #2. There was a significant difference in egress properties across the three cut patterns (p=0.00). The average egress time of Mesh Pattern #1 was 1.97 seconds. The average egress time of Perforation Pattern #2 was 6.50 seconds and of Perforation Pattern #1 was 10.37 seconds.
Quantitative comparison revealed that meshing ADM tissue significantly improves fluid egress properties and substantially increases the surface area compared to ADM tissue perforated at levels typically available on the market. Therefore, the use of meshed ADM tissue could improve the ability of the product to incorporate with the recipient, resulting in improved patient outcomes.
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