Alloplastic Soft Tissue Support: An Overview and Clinical Experience.

Abstract

Control over wound healing in terms of a strong yet durable repair or modulation of the scar response has been the goal of plastic surgeons since the first wound was closed. There has always been the need for soft tissue support, whether the support is for sutures to close wounds, autogenous dermal or fascial grafts, or more recently, alloplastic materials. Within this supplement to Aesthetic Surgery Journal , we explore two distinctively different solutions for alloplastic soft tissue support that we think will be of interest to readers and useful in their clinical practices. ### Alloplastic Soft Tissue Support Options Many factors influence the choice of surgical approach and the specific product used for soft tissue support and repair. The goal is to improve long-term outcomes while minimizing complications and recurrences requiring further revision surgery. As the reader would imagine, there are many different products that have been developed historically for soft tissue support (Figure 1). Not all of these are suitable for the needs of plastic surgery patients, and all of them have their specific limitations. The basic science of these products is intriguing, and this supplement afforded us the opportunity to consider this and showcase some of our own clinical outcomes to add to the information presented. Figure 1. Alloplastic soft tissue support options. “Other Origin” is the class of decellularized tissue made by whole organ perfusion, a new way to harvest the collagen matrix in organs while removing cellular tissue. Some products have a long shelf life and remain in place for years, such as polypropylene mesh or polytetrafluoroethylene. Others become vascularized by host tissues, such as acellular collagen matrix, dermal, or products of other origin.1 However, another class is present for some time and then absorbed by the host tissues, such as poly-4-hydroxybutyrate [P4HB], silk fibroin, and meshes derived from absorbable suture technology. …