Prefabrication of a high-density porous polyethylene implant using a vascular induction technique

Three-dimensional defects have been reconstructed with carved and remodeled frameworks wrapped within vascular carriers and have wide use in ear and nose reconstruction. The main problem with thick coverings is masking of the fine details in the frameworks. Other problems are insufficient blood supply, infection, and exposure of the implant. If sufficient vascular penetration can be established without any change in size and shape of the implant, it will be possible to cover it with a thin skin graft and improve aesthetic results. In this study we planned to prefabricate a high-density porous polyethylene implant that has been used frequently. The implants were placed and anchored underneath the superficial inferior epigastric artery and vein pedicle bilaterally in 10 adult New Zealand White rabbits. Twenty implants were prefabricated in this procedure, and they were evaluated via histological examination and perfusion scintigraphy. Results revealed that the implants were invaded by fibroneovascular tissue. Blood supply coming from the vascular pedicle was sufficient to maintain the implant as a prefabricated composite flap, which could be transferred as a pedicled flap or a free flap.