Prefabricated skin flaps in a rat model based on a dermal replacement matrix Permacol

The reconstruction of three-dimensional structures is one of the most challenging problems in plastic surgery. While shaped frameworks incorporated within soft tissue envelopes often lose their fine detail, the integration of a blood supply to a stable biomaterial scaffold allows skin graft cover and emphasis of fine detail. The aim of this study was to evaluate whether a porcine derived isocyanate crosslinked collagen tissue matrix (Permacol) could be vascularised from an isolated vascular pedicle and subsequently sustain an overlying skin graft as a pedicled prefabricated flap. A vascular induction technique was employed using the epigastric pedicles in Sprague-Dawley rats to vascularise 2 x 2 cm(2) pieces of Permacol of standard 0.75 and 1.5 mm thickness Permacol and laser treated Permacol of 0.4 and 0.75 mm thickness. Flaps were able to support overlying skin grafts as early as 2 weeks following vessel implantation and laser treated Permacol had an increased vascularity compared to standard Permacol with no evidence of degradation. The study showed that Permacol could be a useful matrix for use in tissue engineered flaps.