Some factors that influence prolonged interfacial continuity.

Abstract

Bringing a percutaneous implant through the integument with the intentions of leaving it as a functional device for prolonged periods of time has not yet become a reality. If we are ever to achieve prolonged uninfected implants, attention must be directed toward a variety of failure mechanisms. Some of these mechanisms have defied our scrutiny, and our awareness of others are poorly understood. Some of the causes for failure of a percutaneous implant are the forces, either extrinsic or intrinsic, that cause shearing and tearing at the skin-implant interface. Extrinsic forces are defined as those forces applied either to the skin or the implant by the external environment. Intrinsic forces are those that have to do directly or indirectly with the body's growth and cell maturation, such as the retraction of maturing scar tissue and the surface migration of squamous epithelium. An intact skin-implant interface is important to attain in order to close the portal which might allow microbial invasion. The integument must remain intact, since a suppurative wound makes the implant's removal mandatory.