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Anthony P. Sclafani, MD; Steven A. McCormick, MD; Rubina Cocker, MD

Arch Facial Plast Surg. 2002;4:164-171.

Objectives  To evaluate the microscopic structure and physical properties of homologous tissue grafts commonly used in aesthetic and reconstructive facial plastic surgery in order to determine specific properties of these materials that may affect their performance in vivo.

Methods  Two decellularized dermal materials (AlloDerm and DuraDerm) and 2 fascia lata tissue grafts (Tutoplast and cadaveric fascia lata) were examined by light microscopy (hematoxylin-eosin and Movat staining) and scanning electron microscopy. The physical properties of these materials were also examined for thickness, maximum sustainable load, strain, conformability, and elasticity.

Results  Significant differences in microscopic appearance existed between the 2 dermal materials and the 2 fascial materials. AlloDerm and Tutoplast fascia lata retained architecture closer to that of untreated tissue than did DuraDerm and cadaveric fascia lata, respectively. Tutoplast fascia lata and AlloDerm were also stronger than cadaveric fascia lata and DuraDerm, respectively. AlloDerm retained significantly more elasticity than DuraDerm.

Conclusions  AlloDerm and Tutoplast fascia lata retain more natural architecture and physical properties than do DuraDerm and cadaveric fascia lata, respectively. These differences clearly show the effect of the specific processing of these materials. The alteration in architecture and the degradation of the physical properties of DuraDerm and cadaveric fascia lata may hinder the performance of these grafts in vivo. Further studies on these materials in humans are currently under way.

From the Division of Facial Plastic and Reconstructive Surgery (Drs Sclafani and McCormick) and the Department of Pathology (Drs McCormick and Cocker), The New York Eye & Ear Infirmary, New York. No author holds any financial interests in any of the manufacturers of the tested materials.

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