Background: Integra is an acellular dermal matrix composed of bovine tendon collagen and a glycosaminoglycan, chondroitin-6-sulfate, covered by a silicon sheet. There are no experimental studies to support the use of Integra in avascular wound recipient beds such as bone, tendon, or fascia. The purpose of this study is to evaluate Integra in a rodent model of an avascular wound. Our hypothesis is that Integra will achieve neovascularization and therefore lead to successful wound healing in an avascular wound.

Methods: 24-male Wistar rats were anesthetized and a 3 x 6 cm full thickness wounds were created on the dorsum of each rat. The rats were randomly assigned to three groups: a control group, in which the full thickness skin graft was replaced on the vascular wound bed, an Integra group, in which Integra was placed over the full-thickness wound on the vascular wound bed, and a Fascia/Integra group, in which the spinotrapezius fascia was exposed and Integra was placed over the wound. Biopsies of the matrix-forming neodermis were evaluated histologically at day 14. Vessel counts were determined and ANOVA was used to compare each group. All results are presented in mean +/- SEM.

Results: The control group rats had an average of 6.61 +/- 1.2 vessels per high power field, the Integra-only group had an average of 11.21 +/- 2.1 vessels per high power field, and the Fascia/Integra group had an average of 9.12 +/- 2.2 vessels per high power field. There were no significant statistical differences between the groups.

Conclusion: Integra neovascularization in avascular wounds is similar to revascularization in skin grafts and neovascularization of Integra in vascular recipient beds. These results suggest that Integra may provide an alternative to full-thickness skin grafting, skin expansion, or even flap coverage in wounds with avascular recipient beds.