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Plastic Surgery > Biomaterials > Flashcards

Biomaterials Flashcards

1
Q

What is the most important clinical aspect of an implanted material? and it’s definition?

A
  • Permanence

- Long term biocompatibility between host and implant

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2
Q

Ideal properties for biomaterials

A
  • Biocompatible
  • Chemically inert
  • Non-allergenic
  • Non-carcinogenic
  • Sterilizable
  • Cost effective
  • Easy handling
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3
Q

Biologic reactions to a foreign body

A
  • Rejection
  • Fibrous encapsulation
  • Resorption
  • Incorporation
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4
Q

Biomaterials Classification

A
  • Autograft
  • Allograft
  • Xenograft
  • Alloplast
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5
Q

Biomaterial with most and one with least incorporation

A
  • Most is autograft

- Least is Alloplast

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6
Q

Biomaterial with most and one with least resistance to infection

A
  • Most is autograft

- Least is Alloplast

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7
Q

Biomaterial with most and one with least Antigenicity

A
  • Most is Xenogeraft

- Least are autograft and alloplast

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8
Q

Biomaterial with most and one with least host tissue inflammation reaction

A
  • Most is alloplast

- Least is autograft

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9
Q

Biomaterial with most and one with least infectious disease transmission

A
  • Most are allograft and xenograft

- Least are autograft and alloplast

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10
Q

Biomaterial with most and one with least availability

A
  • Most is alloplast

- Least is autograft

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11
Q

Skin Substitutes (Enumerate)

A
  • Skin Autografts:
    • Split-thickness skin graft (STSG)
    • Full thickness skin graft (FTSG)
    • Cultured epidermal autografts (CEA)
  • Skin allografts and xenografts
  • Acellular dermal matrix (ADM):
    • Allogenic ADMs
    • Xenogenic ADMs
    • Acellular bilayered matrix
    • Cellualr dermal matrix
    • Cellular bilayered matrix
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12
Q

Stages of STSG Take

A
  • Imbibition (24-48 hours): graft obtains nutrients via capillary action
  • Inosculation (48-72 hours): recipient and donor end capillaries align
  • Revascularization (4-6 days): full ingrowth of host capillaries into graft
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13
Q

Thickness of STSG classification

A
  • Thin: 5/1000 - 12/1000 inch
  • Medium: 12/1000 - 16/1000 inch
  • Thick: 16/1000 - 30/1000 inch
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14
Q

Donor sites for STSG

A
  • Thigh
  • Buttock
  • Back
  • Scalp
  • Arm
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15
Q

STSG (Advantages)

A
  • High chance of graft survival
  • Fast revascularization
  • Can reharvest from the same donor site
  • Donor site can regenerate hair
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16
Q

STSG (Disadvantages)

A
  • High degree of secondary contracture (thinner grafts yield more contracture)
  • Poor color and texture match
17
Q

Donor sites for FTSG

A
  • Preauricular and postauricular
  • Supraclavicular
  • Groin
  • Axillary
18
Q

FTSG (Advantages)

A
  • Less secondary contracture
  • Better color and texture match
  • Improved sensory return
19
Q

FTSG (Disadvantages)

A
  • Lower chance of graft survival
  • Slower revascularization
  • Must be able to close donor site primarily
20
Q

CEA (Advantages)

A

Useful in difficult clinical scenarios with limited autologous skin

21
Q

CEA (Disadvantages)

A
  • Expensive
  • Time intensive ( 3 weeks for 10000 fold kerationcyte expansion
  • Grown with murine fibroblasts and fetal calf serum, thus potentiating possible immunologic reaction and rejection of CEA
  • Extremely fragile
22
Q

CEA Example

A

Epicel (Genzyme) the only FDA approved one

23
Q

Acellular Dermal Matrix (ADM) characteristics

A
  • Non living dermal components from an allogenic or xenogenic donor
  • Composed of collagen, elastin, laminin, and glycosaminoglycans
  • Incorporate well into host tissue with revascularization initiated 1 to 2 weeks after implantation
  • More for reinforcing soft tissue and facilitating wound healing rather than actual skin substitute
24
Q

Acellular Dermal Matrix (ADM) Clinical Applications

A
  • Breast reconstruction
  • Abdominal wall reconstruction
  • Chest wall reconstruction
  • Head and neck reconstruction
25
Q

Acellular Dermal Matrix (ADM) for breast reconstruction (Advantages)

A
  • Provide support and additional coverage in implant or expander-based breast reconstructions
  • Shown to help increase intra-operative tissue expansion volume and decrease capsular contracture rate
26
Q

Acellular Dermal Matrix (ADM) for breast reconstruction (Disadvantages)

A
  • Increased seroma rate

- Red breast syndrome: when used with implant or expander (erythema mimicking cellulitis)

27
Q

Acellular Dermal Matrix (ADM) for Abdominal wall reconstruction (Advantages)

A
  • Provides additional strength in hernia repair
  • Helps bridges large abdominal wall defects
  • Favored over synthetic materials in contaminated wounds
28
Q

Acellular Dermal Matrix (ADM) for Chest wall reconstruction (Advantages)

A
  • Serves as regenerative tissue matrix for chronic wounds
  • Has been shown to be an effective bridge to definitive STSG coverage in wounds with exposed nerve,vessel, tendon, bone or cartilage
29
Q

Acellular Dermal Matrix (ADM) for Head and neck reconstruction (Advantages)

A
  • Covers intra oral mucosal defects (floor of mouth and tongue
  • Has been shown to reduce fistula rate in cleft palate repairs
  • Corrects contour deformities of nose
  • Eyelid reconstruction
  • Covers dural defects

Plastic Surgery (3 decks)

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