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Immediate post‐implantation skin immobilization decreases skin regression around percutaneous osseointegrated prosthetic implant systems
Author(s) -
Holt Brian Mueller,
Bachus Kent N.,
Beck James Peter,
Bloebaum Roy Drake,
Jeyapalina Sujee
Publication year - 2013
Publication title -
journal of biomedical materials research part a
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 150
eISSN - 1552-4965
pISSN - 1549-3296
DOI - 10.1002/jbm.a.34510
Subject(s) - osseointegration , materials science , implant , biomedical engineering , percutaneous , fixation (population genetics) , soft tissue , forelimb , surgery , dentistry , medicine , anatomy , population , environmental health
Abstract A percutaneous, osseointegrated (OI) prosthetics are alternative docking systems for upper‐ and lower‐extremity prostheses. Persistent inflammation and micro‐motion are known to cause negative soft‐tissue adaptation in wound healing and may also be detrimental to implant longevity. In this study, a unique single‐stage sheep amputation and implantation model was developed to assess the efficacy of a porous coated sub‐dermal fixation surface in the prevention of skin regression around a percutaneous osseointegrated prosthetic implant. Porous coated and smooth sub‐dermal fixation surface prosthetics were implanted in the right forelimb of skeletally mature sheep for up to 12 months. Skin regression kinetics and sub‐dermal fixation surface coverage were measured from histological samples. Quantitative measurements of porous coated surfaces yielded skin migration rates of 0.90 ± 0.23, 0.56 ± 0.15, 0.44 ± 0.22 mm/month for the 6, 9, and 12 month animals, respectively. In addition, three load dependent regions of skin adaptation were identified; an interface, a transition, and a stress absorbance region. Immediate post‐implantation immobilization of the skin may foster improved load‐bearing percutaneous device outcomes. The skin adaptations reported here will aid in informing the design and optimization of future percutaneous, OI devices intended for the treatment of upper‐ and lower‐extremity amputees. © 2012 Wiley Periodicals, Inc. J Biomed Mater Res Part A, 2013.