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Original Article | ONLINE FIRST

Evaluation of a Sphere-Templated Polymeric Scaffold as a Subcutaneous Implant ONLINE FIRST

Amit D. Bhrany, MD; Colleen A. Irvin, BS; Kenji Fujitani; Zada Liu; Buddy D. Ratner, PhD
Arch Facial Plast Surg. 2012;():1-5. doi:10.1001/archfacial.2013.4.
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Objective  To evaluate the performance of a sphere-templated poly(2-hydroxyethyl methacrylate) (poly[HEMA]) tissue scaffold as a subcutaneous implant by comparing it with widely used high-density porous polyethylene (HDPPE) implant material.

Design  We implanted sphere-templated porous poly-(HEMA) and HDPPE disks into the dorsal subcutis of C57BL/6 mice for 4 and 9 weeks. Excisional biopsy specimens of the implants and surrounding tissue were assessed for host inflammatory response, tissue ingrowth, and neovascularization using trichrome, picrosirius red, and anti–endothelial cell antibody staining.

Results  The poly(HEMA) and HDPPE implants showed resistance to extrusion and elicited a minimal inflammatory response. Both implants supported cellular and collagen ingrowth, but ingrowth within the HDPPE implant was thicker owing to the larger porous structure (>100 μm) of HDPPE, whereas the poly(HEMA) implant had much thinner collagen fibrils within much smaller (40-μm) pores, suggestive of less scar-type reaction. Neovascularization was supported by both implants. Blood vessels were identified within the fibrous ingrowth of the HDPPE and within individual pores of the poly(HEMA).

Conclusions  Sphere-templated poly(HEMA) implanted as a subcutaneous tissue scaffold stimulates a minimal inflammatory response and supports cellular infiltration, collagen formation, and neovascularization. Because of its tightly controlled porous structure, poly-(HEMA) appears to induce less scar-type ingrowth compared with HDPPE.

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Figures

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Figure 1. Trichrome-stained cross-sections of implant materials interfaced with host subcutaneous tissue (asterisk, panniculus carnosus) (original magnification ×4). A, Poly(2-hydroxyethyl methacrylate) (poly[HEMA]) implant. B, High-density porous polyethylene (HDPPE) implant. A thin inflammatory capsule of collagen (double arrows) surrounds the poly(HEMA) implant; a slightly more diffuse, thicker capsule surrounds the HDPPE implant. Both implants had minimal macrophage and neutrophil invasion. The poly(HEMA) implant demonstrates fibroblasts and collagen (blue) infiltrating and interconnecting between 40-μm pores. Tissue ingrowth in the HDPPE implant is present in a more gross fashion because of the presence of much larger porous spaces within the implant.

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Figure 2. Picrosirius red–stained cross-sections of implant materials (original magnification ×4). A, Poly(2-hydroxyethyl methacrylate) (poly[HEMA]) implant. B, High-density porous polyethylene (HDPPE) implant. Images were acquired with cross-polarized microscopy. The white line indicates the boundary between the native host subcutaneous tissue (asterisk, panniculus carnosus) and the tissue capsule surrounding the implant (double arrows). Thicker, disorganized collagen fibrils appear bright yellow or red-orange; thinner, organized fibers are more green-yellow. The poly(HEMA) implant demonstrates more green fibers within and surrounding the implant, similar to native tissue, whereas the HDPPE implant has a higher density of bright yellow and orange fibers.

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Figure 3. Endothelial cell antibody–stained cross-sections demonstrating examples of blood vessels filled with red blood cells present within surrounding host tissue (double arrows) and infiltrating the implants (single arrows). A, Poly(2-hydroxyethyl methacrylate) (poly[HEMA]) implant. B, High-density porous polyethylene (HDPPE) implant.

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