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 2×2 cm2 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.