A subcutaneous implant for wound healing studies in humans

A method for studying wound healing in humans is described. The technique is based on the production of a standard subcutaneous injury during implantation of a retrievable sponge. The injury is produced by introducing a small device (PVA implant) which consists of a 5.7-cm piece of perforated silicone tubing containing two pieces of polyvinyl alcohol sponge. The sponge provides a site for attracting inflammatory cells with subsequent fibroblast infiltration. The sterile PVA implant is inserted subcutaneously in the upper arm by means of a 12-gauge needle and remains there for 14 days. Upon removal, one sponge has hydroxyproline deposition quantitated using a high-performance liquid chromatography technique. The other sponge may be processed for light and electron microscopy or specialty staining. Other collagen determinations such as percentage neutral salt-soluble collagen are also possible. Using the PVA implant has made it possible to follow the kinetics of collagen deposition in the rat. There was a marked increase in collagen accumulation from Day 2 (0.89 nmole/mg sponge) to Day 14 (18 nmole/mg sponge) in the rat. Collagen deposition was also measured in human control subjects (5.07 nmole/mg sponge, n = 12) and compared to trauma patients (2.04 nmole/mg sponge, n = 5). Histologic staining showing fibroblast infiltration and collagen deposition correlated well with the biochemical findings. This implant, coupled with recent HPLC technology, provides a safe, acceptable technique to study human wound healing parameters and overcomes many of the limitations of previous methods.