title: New technique for laryngotracheal mucosa transplantation. 'Stamp' welding using indocyanine green dye and albumin interaction with diode laser.
abstract: OBJECTIVE
  To investigate (1) the possibility of survival of free mucosa "stamp" grafts fixed in the airway with a new technique using indocyanine green-dyed albumin solder activated with a diode laser and (2) the degree of improvement of wound healing in the airway by applying modified microskin transplantation techniques from burn surgery to cover a relatively large wound with a few small pieces of mucosa anchored in place with the previously mentioned technique.
  
  
  METHODS
  Three (one control and two experimental) rectangular (10 x 8 mm) wounds in tracheal mucosa were produced in four experimental animals (dogs) using a carbon dioxide laser. The control wound was left uncovered. In the first experimental wound, a mucosal flap was raised and then fixed in place by a trapdoor flap method. In the second experimental wound, two small (each 2 x 3 mm) autogenous mucosa grafts were anchored onto the surface with indocyanine green-dyed albumin activated with an 810-nm diode laser. Histomorphologically, the postoperative results from three wounds were compared.
  
  
  RESULTS
  The experimental wounds were completely covered by regenerated squamous cells in 1 week and by ciliated epithelium in 2 weeks after the operation despite the discrepancy in size of the graft to wound area (1:6.7) covered with the stamp mucosa. No thermal damage from the diode laser was noted in the second experimental wounds. In the control wounds, no coverage was observed at 1 week, and only squamous cells were noted 2 weeks postoperatively. All the wounds had normal ciliated epithelium coverage at 4 weeks.
  
  
  CONCLUSIONS
  Transplanted stamp grafts provided similar or better healing than trapdoor flap transplants. This new technique made endoscopic mucosal grafting possible and offers a potential breakthrough in the management of laryngotracheal stenosis.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic, Burlington, Mass, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: M M
authors.initials: MM
authors.lastname: Pankratov
authors.forename: L L
authors.initials: LL
authors.lastname: Gleich
authors.forename: E E
authors.initials: EE
authors.lastname: Rebeiz
authors.forename: S M
authors.initials: SM
authors.lastname: Shapshay
mesh_terms: D000418:Albumins / Q000008:administration & dosage*; D000818:Animals; D004285:Dogs; D005500:Follow-Up Studies; D007208:Indocyanine Green / Q000008:administration & dosage*; D007820:Laryngeal Mucosa / Q000033:anatomy & histology / Q000637:transplantation*; D053685:Laser Therapy / Q000379:methods*; D009092:Mucous Membrane / Q000033:anatomy & histology / Q000637:transplantation; D013524:Surgical Flaps / Q000379:methods; D013997:Time Factors; D016378:Tissue Transplantation / Q000379:methods; D014132:Trachea / Q000033:anatomy & histology / Q000293:injuries / Q000637:transplantation*; D014945:Wound Healing
chemical_list: D000418:Albumins; D007208:Indocyanine Green