Novel model of calvarial defect in an infected unfavorable wound: Reconstruction with rhBMP-2. part II

Christopher R. Kinsella, James J. Cray, Darren M. Smith, Stephen Rottgers, Mark P. Mooney, Gregory M. Cooper, Joseph E. Losee

Research output: Contribution to journalArticle

Abstract

Background: Animal models of bone reconstruction have shown recombinant human bone morphogenetic protein 2 (rhBMP-2) to be an effective therapy in the acute calvarial defect wound. The purpose of this study was to compare the effectiveness of rhBMP-2 in a rabbit model of an unfavorable scarred calvarial wound with the criterion standard of autograft. Methods: Nineteen adult New Zealand white rabbits underwent subtotal calvariectomy. After 6 weeks of healing and normal scar formation, these animals underwent reoperation for scar debridement and assignment to 1 of 4 therapeutic groups. Animals were assigned to an empty control group (no treatment, n = 3), vehicle control group (neutral buffered solution on an absorbable collagen sponge [ACS], n = 3), surgical control group (cryopreserved autograft, n = 3), or an experimental treatment group (rhBMP-2 on an ACS, n = 10). All animals underwent computed tomography imaging at 0, 2, 4, and 6 weeks after secondary reconstructive surgery. At 6 weeks, all animals were killed, and the defects were examined histologically. Percentage of healing of each defect was determined, and a 4 × 3 mixed-model analysis of variance was performed on healing as a function of time and therapy. Results: Based on measures of defect radiopacity, the treatment group (rhBMP-2/ACS) and surgical control group (autograft) were statistically equivalent with 98% and 83% healing, respectively, at 6 weeks. The empty control and vehicle control groups were inferior to the treatment group (rhBMP-2/ACS) and surgical control (autograft) groups at each timepoint (P <0.05). Histologically, bone in the surgical control (autograft) group was less trabecular and less cellular than the bone formed in the experimental treatment group (rhBMP-2/ACS). Conclusions: Compared with historical controls, rhBMP-2 therapy was as effective in reconstructing calvarial defects in the unfavorable scarred wound as in the acute favorable calvarial wound. When compared with cryopreserved autograft, rhBMP-2-regenerated bone showed equal defect coverage and similar bone thickness with varying bony architecture.

Original languageEnglish (US)
Pages (from-to)410-414
Number of pages5
JournalThe Journal of craniofacial surgery
Volume23
Issue number2
DOIs
StatePublished - Mar 2012
Externally publishedYes

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Autografts
Wounds and Injuries
Control Groups
Collagen
Surgical Sponges
Porifera
Bone and Bones
Cicatrix
Reconstructive Surgical Procedures
Rabbits
recombinant human bone morphogenetic protein-2
Debridement
Therapeutics
Reoperation
Analysis of Variance
Animal Models
Tomography

Keywords

  • autograft
  • BMP
  • cranial reconstruction
  • rabbit
  • rhBMP-2

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery

Cite this

Novel model of calvarial defect in an infected unfavorable wound : Reconstruction with rhBMP-2. part II. / Kinsella, Christopher R.; Cray, James J.; Smith, Darren M.; Rottgers, Stephen; Mooney, Mark P.; Cooper, Gregory M.; Losee, Joseph E.

In: The Journal of craniofacial surgery, Vol. 23, No. 2, 03.2012, p. 410-414.

Research output: Contribution to journalArticle

Kinsella, Christopher R. ; Cray, James J. ; Smith, Darren M. ; Rottgers, Stephen ; Mooney, Mark P. ; Cooper, Gregory M. ; Losee, Joseph E. / Novel model of calvarial defect in an infected unfavorable wound : Reconstruction with rhBMP-2. part II. In: The Journal of craniofacial surgery. 2012 ; Vol. 23, No. 2. pp. 410-414.
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AU - Smith, Darren M.

AU - Rottgers, Stephen

AU - Mooney, Mark P.

AU - Cooper, Gregory M.

AU - Losee, Joseph E.

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N2 - Background: Animal models of bone reconstruction have shown recombinant human bone morphogenetic protein 2 (rhBMP-2) to be an effective therapy in the acute calvarial defect wound. The purpose of this study was to compare the effectiveness of rhBMP-2 in a rabbit model of an unfavorable scarred calvarial wound with the criterion standard of autograft. Methods: Nineteen adult New Zealand white rabbits underwent subtotal calvariectomy. After 6 weeks of healing and normal scar formation, these animals underwent reoperation for scar debridement and assignment to 1 of 4 therapeutic groups. Animals were assigned to an empty control group (no treatment, n = 3), vehicle control group (neutral buffered solution on an absorbable collagen sponge [ACS], n = 3), surgical control group (cryopreserved autograft, n = 3), or an experimental treatment group (rhBMP-2 on an ACS, n = 10). All animals underwent computed tomography imaging at 0, 2, 4, and 6 weeks after secondary reconstructive surgery. At 6 weeks, all animals were killed, and the defects were examined histologically. Percentage of healing of each defect was determined, and a 4 × 3 mixed-model analysis of variance was performed on healing as a function of time and therapy. Results: Based on measures of defect radiopacity, the treatment group (rhBMP-2/ACS) and surgical control group (autograft) were statistically equivalent with 98% and 83% healing, respectively, at 6 weeks. The empty control and vehicle control groups were inferior to the treatment group (rhBMP-2/ACS) and surgical control (autograft) groups at each timepoint (P <0.05). Histologically, bone in the surgical control (autograft) group was less trabecular and less cellular than the bone formed in the experimental treatment group (rhBMP-2/ACS). Conclusions: Compared with historical controls, rhBMP-2 therapy was as effective in reconstructing calvarial defects in the unfavorable scarred wound as in the acute favorable calvarial wound. When compared with cryopreserved autograft, rhBMP-2-regenerated bone showed equal defect coverage and similar bone thickness with varying bony architecture.

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