Various methods have been employed to reconstruct complex abdominal wall defects. Structural pros... more Various methods have been employed to reconstruct complex abdominal wall defects. Structural prosthetic materials such as polypropylene mesh and ePTFE (expanded polytetrafluoroethylene) have been widely used to close these large fascial defects, however, complications with infection and adhesions have led to the recent use of more biocompatible implants. Permacol (acellular porcine dermis) is used as a dermal scaffold, which eventually becomes vascularised and remodelled to reconstruct the abdominal wall in these complex patients.
Occult injuries to arteries are common in trauma and evolution of their repair has been observed ... more Occult injuries to arteries are common in trauma and evolution of their repair has been observed throughout military conflicts. Currently, autogenous vein and polytetrafluoroethylene (PTFE) are used as patch agents for arterial trauma. However, suitable vein is often lacking in multitrauma patients, and PTFE is prone to infection in the contaminated combat wound. The purpose of this study is to evaluate Permacol, porcine dermal collagen, and Alloderm, acellular cadaveric dermis, as suitable alternatives to PTFE with the potential benefit of being used in contaminated wounds. A New Zealand White rabbit common carotid arteriotomy model was used to compare Permacol (n = 12), Alloderm (n = 11), and PTFE (n = 13) for patch repair. Thrombin generation was examined using an enzyme-linked immunosorbent assay for thrombin-antithrombin complex. Histological samples were taken to analyze vessel lumen area, vessel diameter, intimal thickness, and medial thickness. Pathological examinations were made to compare rates of intimal hyperplasia, aneurysm, patency, and thrombus formation. The Permacol group showed equivalent rates of thrombus, aneurysm, and patency compared with PTFE. Increased lumen area was seen in the Permacol group, 0.344 mm2 (p = 0.02) compared with the PTFE group, 0.204 mm2. Permacol also had decreased incidence of intimal hyperplasia compared with PTFE, 50.0% versus 92% (p < 0.05). Alloderm had increased rates of aneurysm formation, 63.6% (p = 0.004) compared with PTFE, 0.0%, and Permacol groups, 8.3%. Alloderm also had increased intimal thickness through the patch, 0.076 mm (p = 0.18), compared with PTFE, 0.026 mm, and Permacol groups, 0.024 mm. Vessel diameter through the patch showed the Alloderm group, 1.87 mm (p = 0.004), was significantly larger than both the Permacol, 1.41 mm, and PTFE groups, 1.28 mm. Furthermore, Alloderm showed leukocyte migration around the patch. Enzyme-linked immunosorbent assay for thrombin-antithrombin complex was only elevated for PTFE in the 7-day postoperative measurement but was not statistically different from the other groups. Permacol has characteristics to be an effective alternative for PTFE for patch arteriotomy repair in our rabbit model. Futher studies need to be conducted to investigate the potential of Permacol in vascular trauma. Alloderm is not a suitable alternative to PTFE for patch arteriotomy repair.
Les l esions traumatiques occultes des art eres sont fr equentes en traumatologie et une evolutio... more Les l esions traumatiques occultes des art eres sont fr equentes en traumatologie et une evolution de leur r eparation a et e observ ee lors des conflits militaires. Actuellement, la veine autog ene et le polyt etrafluoro ethyl ene (PTFE) sont employ es comme patchs pour les traumatismes art eriels. Cependant, une veine adapt ee manque souvent chez les polytraumatis es, et le PTFE est susceptible a l'infection dans une plaie de guerre souill ee. Le but de cette etude est d' evaluer Permacol, collag ene cutan e porcin, et Alloderm, derme cadav erique acellulaire, comme alternative au PTFE satisfaisante avec l'avantage potentiel de l'utilisation dans les plaies souill ees. Un mod ele d'art eriotomie carotide commune chez le lapin blanc de Nouvelle Z elande a et e employ e pour comparer Permacol (n ¼ 12), Alloderm (n ¼ 11), et le PTFE (n ¼ 13) comme patchs. La formation de thrombine a et e examin ee en employant un test ELISA pour le complexe thrombineantithrombine. Des echantillons histologiques ont et e pr elev es pour analyser la lumi ere art erielle, le diam etre art eriel, l' epaisseur intimale, et l' epaisseur m ediale. Des examens pathologiques ont et e faits pour comparer les taux d'hyperplasie, d'an evrismes, de perm eabilit e, et de formation de thrombus intimal. Le groupe Permacol avait des taux de thrombus, d'an evrismes, et de perm eabilit e similaires au PTFE. La surface luminale
Las lesiones arteriales ocultas son frecuentes en casos de traumatismos y los diferentes conflict... more Las lesiones arteriales ocultas son frecuentes en casos de traumatismos y los diferentes conflictos militares han permitido observar la evoluci on de su correcci on. En la actualidad se utilizan venas aut ologas y politetrafluoroetileno (PTFE) como parches para traumatismos arteriales. Sin embargo, a menudo no se dispone de una vena adecuada en pacientes politraumatizados, y el PTFE tiende a infectarse en las heridas de combate contaminadas. El objetivo de este estudio consiste en evaluar Permacol, un col ageno d ermico porcino, y Alloderm, dermis acelular de cad aver, como alternativas v alidas al PTFE con la ventaja potencial de ser utilizados en las heridas contaminadas. La arteriotom ıa carot ıdea com un en conejos New Zealand White se utiliz o como modelo para comparar la correcci on mediante parches de Permacol (n ¼ 12), Alloderm (n ¼ 11) y PTFE (n ¼ 13). Se examin o la formaci on de trombina utilizando un ensayo ELISA para el complejo trombina-antitrombina. Se obtuvieron muestras histol ogicas para analizar el area de la luz vascular, el di ametro del vaso, el espesor de la ıntima, y el grosor de la media. Se llevaron a cabo los estudios anatomopatol ogicos para comparar las tasas de hiperplasia de la ıntima, aneurisma, permeabilidad y formaci on de trombos. El grupo con Permacol mostr o tasas equivalentes de trombos, aneurisma y permeabilidad en comparaci on con el PTFE. En el grupo con Permacol tambi en se observ o un aumento del area luminal, 0,344 mm 2 (p ¼ 0,02) en comparaci on con el grupo PTFE, 0,204 mm 2 .A s ı mismo, este present o una menor incidencia de hiperplasia de la ıntima en comparaci on con el grupo PTFE, 50,0 frente al 92% (p < 0,05). El grupo con Alloderm present o tasas m as elevadas de formaci on de aneurisma, 63,6% (p ¼ 0,004) en comparaci on con los grupos con PTFE, 0,0%, y Permacol, 8,3%. Adem as, este present o un aumento del grosor de la ıntima en la zona del parche, 0,076 mm (p ¼ 0,18), en comparaci on con los grupos con PTFE, 0,026 mm, y Permacol, 0,024 mm. El di ametro del vaso en la zona del parche en el grupo con Alloderm, 1,87 mm (p ¼ 0,004), fue significativamente mayor que el de los grupos con Permacol, 1,41 mm, y PTFE, 1,28 mm. As ı mismo, el grupo con Alloderm present o migraci on leucocitaria alrededor del parche. El ELISA del complejo trombina-antitrombina solamente estuvo elevado en el grupo con PTFE durante el 7. d ıa del postoperatorio, pero no difiri o de forma estad ısticamente
Background This study compared two porcine-derived grafts Permacol (Tissue Science Laboratory, Co... more Background This study compared two porcine-derived grafts Permacol (Tissue Science Laboratory, Covington, GA, USA) and Surgisis (Cook Surgical, Bloomington, IN, USA) in terms of strength of incorporation (SOI), incorporation of host tissue, and adhesion formation using a rat model. Methods A prospective randomized study using 48 Sprague–Dawley rats. A standardized 1.5 × 5 cm fascial defect was created and repaired with either Permacol or Surgisis grafts. The rats were then sacrificed at 3, 14, 28, or 60 days. The specimens were examined for SOI, neovascularization, collagen deposition, collagen organization, and adhesion formation. Results Surgisis had significantly greater SOI than Permacol at 28 (0.115 vs. 0.0754 Mpa) and 60 days (0.131 vs. 0.635 Mpa). Surgisis had significantly more collagen deposition and neovascularization than Permacol at 60 days. The area of adhesions was not significantly different between Surgisis and Permacol. Conclusion Surgisis is superior to Permacol in terms of SOI and tissue ingrowth at 60 days. Furthermore, Surgisis strengthened over time whereas Permacol decreased in strength.
Background Distal ischemic necrosis of surgical flaps remains a challenging problem for the recon... more Background Distal ischemic necrosis of surgical flaps remains a challenging problem for the reconstructive surgeon. Recent studies have shown that either sildenafil or vascular endothelium growth factor (VEGF) treatment significantly improves ischemic skin flap viability. In this study, the effect of the combination of sildenafil and VEGF165 was evaluated on a rat skin flap model using orthogonal polarization spectral imaging and histologic analysis. Methods Rats were assigned to either a sham (n = 31), vehicle (n = 24), sildenafil (n = 24), VEGF (n = 23), or sildenafil and VEGF combination treatment (n = 21) groups. Distances from the distal end of the flap to avascular, stasis, and normal capillary blood flow zones were determined using orthogonal polarization spectral imaging on a skin flap model. Vessel density assessment was done at 7 days post surgery. Results Imaging analysis showed significant reduction in avascular and stasis areas in sildenafil and VEGF combination-treated groups at 7 days post surgery (p < 0.05). The combination-treated group, however, was not significantly different when compared to the group treated with sildenafil only. The sildenafil-treated group showed a significant (p < 0.05) reduction in both areas at day 7 compared to the VEGF and control groups. Histologic analysis showed no significant differences in vessel density between the groups. Conclusion The combination of sildenafil and VEGF decreases the extent of avascular and stasis zones in skin flaps. The skin flap improvement seen with the combination treatment was similar to the sildenafil treatment alone suggesting that enhanced flap survival was due solely to the effect of sildenafil.
Background Surgisis® and AlloDerm®, two biosynthetic materials, have been previously used with su... more Background Surgisis® and AlloDerm®, two biosynthetic materials, have been previously used with success in abdominal wall repairs in the setting of contaminated fields. Historically, Vicryl Woven Mesh®, a synthetic material, has also been used in such settings as a temporary bridge for abdominal wall reconstruction. This study compares Surgisis and AlloDerm with Vicryl Woven Mesh with respect to tensile strength, collagen remodeling, and neovascularization using a rat hernia model. Methods A prospective randomized trial of 54 Sprague-Dawley rats were assigned to the Surgisis, AlloDerm, or Vicryl Woven Mesh group with baseline, 30-day, and 60-day end points. A 1.5-cm × 5.0-cm defect was created in the right abdominis rectus muscle and repaired with an underlay bridge graft using the different treatment materials. Tensile strength was measured using an Instron tensiometer. Histologic specimens were evaluated for neovascularization, collagen deposition, and collagen organization at the 30- and 60-day time points. Results Surgisis had significantly greater tensile strength compared to Vicryl Woven Mesh at the baseline time point (0.142 vs. 0.091 MPa, p < 0.05). There were no differences between groups tensile strength at 30 or 60 days postoperatively. The Vicryl Woven Mesh and AlloDerm groups showed increases in tensile strength at 30 days postoperatively versus baseline (p < 0.05). Vicryl Woven Mesh, Surgisis, and AlloDerm all showed increases in tensile strength at 60 days postoperatively compared to 30 days postoperatively and at baseline (p < 0.05). Surgisis and AlloDerm had significantly greater (p < 0.05) amounts of collagen deposition and organization at 30 and 60 days compared to Vicryl Woven Mesh. There was no significant difference between AlloDerm and Surgisis with respect to collagen deposition and organization. Surgisis and AlloDerm showed a significantly greater amount (p < 0.05) of neovascularization than Vicryl Woven Mesh at both time points. In addition, Surgisis had a significantly greater amount (p < 0.05) of neovascularization than AlloDerm at both 30 and 60 days. Conclusion Surgisis has increased baseline tensile strength compared to Vicryl Woven Mesh. Tensile strength in Vicryl Woven Mesh is equal to biosynthetic grafts after tissue incorporation. Biosynthetic grafts showed superior collagen deposition and organization. Surgisis mesh showed increased neovascularization over both AlloDerm and Vicryl Woven Mesh.
Various methods have been employed to reconstruct complex abdominal wall defects. Structural pros... more Various methods have been employed to reconstruct complex abdominal wall defects. Structural prosthetic materials such as polypropylene mesh and ePTFE (expanded polytetrafluoroethylene) have been widely used to close these large fascial defects, however, complications with infection and adhesions have led to the recent use of more biocompatible implants. Permacol (acellular porcine dermis) is used as a dermal scaffold, which eventually becomes vascularised and remodelled to reconstruct the abdominal wall in these complex patients.
Occult injuries to arteries are common in trauma and evolution of their repair has been observed ... more Occult injuries to arteries are common in trauma and evolution of their repair has been observed throughout military conflicts. Currently, autogenous vein and polytetrafluoroethylene (PTFE) are used as patch agents for arterial trauma. However, suitable vein is often lacking in multitrauma patients, and PTFE is prone to infection in the contaminated combat wound. The purpose of this study is to evaluate Permacol, porcine dermal collagen, and Alloderm, acellular cadaveric dermis, as suitable alternatives to PTFE with the potential benefit of being used in contaminated wounds. A New Zealand White rabbit common carotid arteriotomy model was used to compare Permacol (n = 12), Alloderm (n = 11), and PTFE (n = 13) for patch repair. Thrombin generation was examined using an enzyme-linked immunosorbent assay for thrombin-antithrombin complex. Histological samples were taken to analyze vessel lumen area, vessel diameter, intimal thickness, and medial thickness. Pathological examinations were made to compare rates of intimal hyperplasia, aneurysm, patency, and thrombus formation. The Permacol group showed equivalent rates of thrombus, aneurysm, and patency compared with PTFE. Increased lumen area was seen in the Permacol group, 0.344 mm2 (p = 0.02) compared with the PTFE group, 0.204 mm2. Permacol also had decreased incidence of intimal hyperplasia compared with PTFE, 50.0% versus 92% (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Alloderm had increased rates of aneurysm formation, 63.6% (p = 0.004) compared with PTFE, 0.0%, and Permacol groups, 8.3%. Alloderm also had increased intimal thickness through the patch, 0.076 mm (p = 0.18), compared with PTFE, 0.026 mm, and Permacol groups, 0.024 mm. Vessel diameter through the patch showed the Alloderm group, 1.87 mm (p = 0.004), was significantly larger than both the Permacol, 1.41 mm, and PTFE groups, 1.28 mm. Furthermore, Alloderm showed leukocyte migration around the patch. Enzyme-linked immunosorbent assay for thrombin-antithrombin complex was only elevated for PTFE in the 7-day postoperative measurement but was not statistically different from the other groups. Permacol has characteristics to be an effective alternative for PTFE for patch arteriotomy repair in our rabbit model. Futher studies need to be conducted to investigate the potential of Permacol in vascular trauma. Alloderm is not a suitable alternative to PTFE for patch arteriotomy repair.
Les l esions traumatiques occultes des art eres sont fr equentes en traumatologie et une evolutio... more Les l esions traumatiques occultes des art eres sont fr equentes en traumatologie et une evolution de leur r eparation a et e observ ee lors des conflits militaires. Actuellement, la veine autog ene et le polyt etrafluoro ethyl ene (PTFE) sont employ es comme patchs pour les traumatismes art eriels. Cependant, une veine adapt ee manque souvent chez les polytraumatis es, et le PTFE est susceptible a l'infection dans une plaie de guerre souill ee. Le but de cette etude est d' evaluer Permacol, collag ene cutan e porcin, et Alloderm, derme cadav erique acellulaire, comme alternative au PTFE satisfaisante avec l'avantage potentiel de l'utilisation dans les plaies souill ees. Un mod ele d'art eriotomie carotide commune chez le lapin blanc de Nouvelle Z elande a et e employ e pour comparer Permacol (n ¼ 12), Alloderm (n ¼ 11), et le PTFE (n ¼ 13) comme patchs. La formation de thrombine a et e examin ee en employant un test ELISA pour le complexe thrombineantithrombine. Des echantillons histologiques ont et e pr elev es pour analyser la lumi ere art erielle, le diam etre art eriel, l' epaisseur intimale, et l' epaisseur m ediale. Des examens pathologiques ont et e faits pour comparer les taux d'hyperplasie, d'an evrismes, de perm eabilit e, et de formation de thrombus intimal. Le groupe Permacol avait des taux de thrombus, d'an evrismes, et de perm eabilit e similaires au PTFE. La surface luminale
Las lesiones arteriales ocultas son frecuentes en casos de traumatismos y los diferentes conflict... more Las lesiones arteriales ocultas son frecuentes en casos de traumatismos y los diferentes conflictos militares han permitido observar la evoluci on de su correcci on. En la actualidad se utilizan venas aut ologas y politetrafluoroetileno (PTFE) como parches para traumatismos arteriales. Sin embargo, a menudo no se dispone de una vena adecuada en pacientes politraumatizados, y el PTFE tiende a infectarse en las heridas de combate contaminadas. El objetivo de este estudio consiste en evaluar Permacol, un col ageno d ermico porcino, y Alloderm, dermis acelular de cad aver, como alternativas v alidas al PTFE con la ventaja potencial de ser utilizados en las heridas contaminadas. La arteriotom ıa carot ıdea com un en conejos New Zealand White se utiliz o como modelo para comparar la correcci on mediante parches de Permacol (n ¼ 12), Alloderm (n ¼ 11) y PTFE (n ¼ 13). Se examin o la formaci on de trombina utilizando un ensayo ELISA para el complejo trombina-antitrombina. Se obtuvieron muestras histol ogicas para analizar el area de la luz vascular, el di ametro del vaso, el espesor de la ıntima, y el grosor de la media. Se llevaron a cabo los estudios anatomopatol ogicos para comparar las tasas de hiperplasia de la ıntima, aneurisma, permeabilidad y formaci on de trombos. El grupo con Permacol mostr o tasas equivalentes de trombos, aneurisma y permeabilidad en comparaci on con el PTFE. En el grupo con Permacol tambi en se observ o un aumento del area luminal, 0,344 mm 2 (p ¼ 0,02) en comparaci on con el grupo PTFE, 0,204 mm 2 .A s ı mismo, este present o una menor incidencia de hiperplasia de la ıntima en comparaci on con el grupo PTFE, 50,0 frente al 92% (p < 0,05). El grupo con Alloderm present o tasas m as elevadas de formaci on de aneurisma, 63,6% (p ¼ 0,004) en comparaci on con los grupos con PTFE, 0,0%, y Permacol, 8,3%. Adem as, este present o un aumento del grosor de la ıntima en la zona del parche, 0,076 mm (p ¼ 0,18), en comparaci on con los grupos con PTFE, 0,026 mm, y Permacol, 0,024 mm. El di ametro del vaso en la zona del parche en el grupo con Alloderm, 1,87 mm (p ¼ 0,004), fue significativamente mayor que el de los grupos con Permacol, 1,41 mm, y PTFE, 1,28 mm. As ı mismo, el grupo con Alloderm present o migraci on leucocitaria alrededor del parche. El ELISA del complejo trombina-antitrombina solamente estuvo elevado en el grupo con PTFE durante el 7. d ıa del postoperatorio, pero no difiri o de forma estad ısticamente
Background This study compared two porcine-derived grafts Permacol (Tissue Science Laboratory, Co... more Background This study compared two porcine-derived grafts Permacol (Tissue Science Laboratory, Covington, GA, USA) and Surgisis (Cook Surgical, Bloomington, IN, USA) in terms of strength of incorporation (SOI), incorporation of host tissue, and adhesion formation using a rat model. Methods A prospective randomized study using 48 Sprague–Dawley rats. A standardized 1.5 × 5 cm fascial defect was created and repaired with either Permacol or Surgisis grafts. The rats were then sacrificed at 3, 14, 28, or 60 days. The specimens were examined for SOI, neovascularization, collagen deposition, collagen organization, and adhesion formation. Results Surgisis had significantly greater SOI than Permacol at 28 (0.115 vs. 0.0754 Mpa) and 60 days (0.131 vs. 0.635 Mpa). Surgisis had significantly more collagen deposition and neovascularization than Permacol at 60 days. The area of adhesions was not significantly different between Surgisis and Permacol. Conclusion Surgisis is superior to Permacol in terms of SOI and tissue ingrowth at 60 days. Furthermore, Surgisis strengthened over time whereas Permacol decreased in strength.
Background Distal ischemic necrosis of surgical flaps remains a challenging problem for the recon... more Background Distal ischemic necrosis of surgical flaps remains a challenging problem for the reconstructive surgeon. Recent studies have shown that either sildenafil or vascular endothelium growth factor (VEGF) treatment significantly improves ischemic skin flap viability. In this study, the effect of the combination of sildenafil and VEGF165 was evaluated on a rat skin flap model using orthogonal polarization spectral imaging and histologic analysis. Methods Rats were assigned to either a sham (n = 31), vehicle (n = 24), sildenafil (n = 24), VEGF (n = 23), or sildenafil and VEGF combination treatment (n = 21) groups. Distances from the distal end of the flap to avascular, stasis, and normal capillary blood flow zones were determined using orthogonal polarization spectral imaging on a skin flap model. Vessel density assessment was done at 7 days post surgery. Results Imaging analysis showed significant reduction in avascular and stasis areas in sildenafil and VEGF combination-treated groups at 7 days post surgery (p < 0.05). The combination-treated group, however, was not significantly different when compared to the group treated with sildenafil only. The sildenafil-treated group showed a significant (p < 0.05) reduction in both areas at day 7 compared to the VEGF and control groups. Histologic analysis showed no significant differences in vessel density between the groups. Conclusion The combination of sildenafil and VEGF decreases the extent of avascular and stasis zones in skin flaps. The skin flap improvement seen with the combination treatment was similar to the sildenafil treatment alone suggesting that enhanced flap survival was due solely to the effect of sildenafil.
Background Surgisis® and AlloDerm®, two biosynthetic materials, have been previously used with su... more Background Surgisis® and AlloDerm®, two biosynthetic materials, have been previously used with success in abdominal wall repairs in the setting of contaminated fields. Historically, Vicryl Woven Mesh®, a synthetic material, has also been used in such settings as a temporary bridge for abdominal wall reconstruction. This study compares Surgisis and AlloDerm with Vicryl Woven Mesh with respect to tensile strength, collagen remodeling, and neovascularization using a rat hernia model. Methods A prospective randomized trial of 54 Sprague-Dawley rats were assigned to the Surgisis, AlloDerm, or Vicryl Woven Mesh group with baseline, 30-day, and 60-day end points. A 1.5-cm × 5.0-cm defect was created in the right abdominis rectus muscle and repaired with an underlay bridge graft using the different treatment materials. Tensile strength was measured using an Instron tensiometer. Histologic specimens were evaluated for neovascularization, collagen deposition, and collagen organization at the 30- and 60-day time points. Results Surgisis had significantly greater tensile strength compared to Vicryl Woven Mesh at the baseline time point (0.142 vs. 0.091 MPa, p < 0.05). There were no differences between groups tensile strength at 30 or 60 days postoperatively. The Vicryl Woven Mesh and AlloDerm groups showed increases in tensile strength at 30 days postoperatively versus baseline (p < 0.05). Vicryl Woven Mesh, Surgisis, and AlloDerm all showed increases in tensile strength at 60 days postoperatively compared to 30 days postoperatively and at baseline (p < 0.05). Surgisis and AlloDerm had significantly greater (p < 0.05) amounts of collagen deposition and organization at 30 and 60 days compared to Vicryl Woven Mesh. There was no significant difference between AlloDerm and Surgisis with respect to collagen deposition and organization. Surgisis and AlloDerm showed a significantly greater amount (p < 0.05) of neovascularization than Vicryl Woven Mesh at both time points. In addition, Surgisis had a significantly greater amount (p < 0.05) of neovascularization than AlloDerm at both 30 and 60 days. Conclusion Surgisis has increased baseline tensile strength compared to Vicryl Woven Mesh. Tensile strength in Vicryl Woven Mesh is equal to biosynthetic grafts after tissue incorporation. Biosynthetic grafts showed superior collagen deposition and organization. Surgisis mesh showed increased neovascularization over both AlloDerm and Vicryl Woven Mesh.
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