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Transcutaneous implants: reactions of the skin-implant interface.

One method of providing an artificial limb for an amputee might be to attach the external prosthesis directly to the skeleton but a major problem is the behavior of the tissues at the point where the prosthesis penetrates the skin surface. Preliminary experiments have been carried out using small flexible implants in porcine skin to study the principles involved. It is confirmed that the epidermis grows down into the dermis around the nonporous materials and the implant-skin junction is unstable and readily becomes infected. It was found that polytetrafluorethylene with pores of 10 μm diameter and hydron sponge with pores of 40 μm diameter became invaded by fibrous tissue and this appeared to prevent the migration of epidermis alongside the implants and a stable ring of epidermal tissue was formed near the skin surface. A review of other situations where epidermal migration is taking place suggests that epidermis is able to migrate through damaged collagenous tissue, possibly with the help of leucocytic enzymes, but that epidermal cell movement is halted when the epidermal sheet is confronted by heathly collagen bundles.