Emre Vural1, Nathan McLaughlin, William R Hogue, Larry J Suva. 1. Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, John McClellan VA Hospital, Little Rock, Arkansas 72205, USA. vuralemrea@uams.edu
Abstract
BACKGROUND: Static slings are one of the most commonly used surgical rehabilitation methods in the management of chronic facial paralysis. Acellular human cadaveric dermis (Alloderm; Life Cell Corp., Branchburg, NJ) is used for this purpose; however, it has variable stretching properties that may necessitate additional "tuning-up" procedure(s). Acellular porcine dermis (Enduragen; Tissue Sciences Laboratories, plc., Aldershot, U.K.) was recently introduced as a biologic implant and it is compositionally similar to Alloderm. However, no data currently exist regarding its biomechanical properties and potential use as an alternative implant to Alloderm in static facial sling procedures. OBJECTIVE: The objective of this study was to compare the biomechanical properties of Alloderm and Enduragen for static facial sling procedures in the management of the paralytic face. STUDY DESIGN: This study consisted of an in vitro prospective study in an academic medical research setting. METHODS: Same size and thickness Alloderm and Enduragen samples were tested with MTS 858 Bionix materials test system for load-to-failure, displacement under increasing and constant stress, and stiffness. RESULTS: Enduragen showed significantly less elongation under increasing stress and at the beginning of constant stress. Load-to-failure and stiffness were significantly higher in Alloderm; however, both biomaterials have adequate stiffness and load-to-failure for a static facial sling procedure. CONCLUSIONS: Enduragen may serve as another potential static facial sling material, because it stretches significantly less than Alloderm under stress. Clinical experience is needed with Enduragen to determine its potential use as a static facial sling material.
BACKGROUND: Static slings are one of the most commonly used surgical rehabilitation methods in the management of chronic facial paralysis. Acellular human cadaveric dermis (Alloderm; Life Cell Corp., Branchburg, NJ) is used for this purpose; however, it has variable stretching properties that may necessitate additional "tuning-up" procedure(s). Acellular porcine dermis (Enduragen; Tissue Sciences Laboratories, plc., Aldershot, U.K.) was recently introduced as a biologic implant and it is compositionally similar to Alloderm. However, no data currently exist regarding its biomechanical properties and potential use as an alternative implant to Alloderm in static facial sling procedures. OBJECTIVE: The objective of this study was to compare the biomechanical properties of Alloderm and Enduragen for static facial sling procedures in the management of the paralytic face. STUDY DESIGN: This study consisted of an in vitro prospective study in an academic medical research setting. METHODS: Same size and thickness Alloderm and Enduragen samples were tested with MTS 858 Bionix materials test system for load-to-failure, displacement under increasing and constant stress, and stiffness. RESULTS: Enduragen showed significantly less elongation under increasing stress and at the beginning of constant stress. Load-to-failure and stiffness were significantly higher in Alloderm; however, both biomaterials have adequate stiffness and load-to-failure for a static facial sling procedure. CONCLUSIONS: Enduragen may serve as another potential static facial sling material, because it stretches significantly less than Alloderm under stress. Clinical experience is needed with Enduragen to determine its potential use as a static facial sling material.