Vural Emre, McLaughlin Nathan, Hogue William R, Suva Larry J
Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, John McClellan VA Hospital, Little Rock, Arkansas 72205, USA.
Laryngoscope. 2006 Mar;116(3):394-6. doi: 10.1097/01.mlg.0000194691.32551.24.
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.
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.
This study consisted of an in vitro prospective study in an academic medical research setting.
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.
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.
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.
静态悬吊是慢性面瘫治疗中最常用的手术康复方法之一。脱细胞人尸体真皮（Alloderm；Life Cell Corp.，Branchburg，新泽西州）用于此目的；然而，它具有可变的拉伸特性，可能需要额外的“微调”程序。脱细胞猪真皮（Enduragen；Tissue Sciences Laboratories，plc.，Aldershot，英国）最近作为一种生物植入物被引入，其成分与Alloderm相似。然而，目前尚无关于其生物力学特性以及在静态面部悬吊手术中作为Alloderm替代植入物的潜在用途的数据。
本研究的目的是比较Alloderm和Enduragen在面瘫治疗的静态面部悬吊手术中的生物力学特性。
本研究包括在学术医学研究环境中进行的体外前瞻性研究。
使用MTS 858 Bionix材料测试系统对相同尺寸和厚度的Alloderm和Enduragen样本进行破坏载荷、应力增加和恒定应力下的位移以及刚度测试。
在应力增加时以及恒定应力开始时，Enduragen的伸长明显较少。Alloderm的破坏载荷和刚度明显更高；然而，两种生物材料对于静态面部悬吊手术都具有足够的刚度和破坏载荷。
Enduragen可能作为另一种潜在的静态面部悬吊材料，因为它在应力下的拉伸明显小于Alloderm。需要Enduragen的临床经验来确定其作为静态面部悬吊材料的潜在用途。
