Tracheal reconstruction with a synthetic material in a porcine model.
The technique of tracheal reconstruction with costal cartilage or a pericardial patch has resulted in successful management of many patients with tracheal stenosis. Yet, it is often difficult, if not impossible, to harvest enough cartilage in a neonate. Pericardial patches are flimsy and can collapse. This pilot study evaluated the use of absorbable plates made of an alloplastic material, Lactosorb, as a substitute for cartilage on a growing porcine trachea. The rectangular plates were fashioned into an inverted U and placed into the airway through an anterior tracheal split. This placement resulted in granulation formation and failure. The plates were then fashioned into an I configuration and placed inside and outside the tracheal lumen. This attempt also resulted in failure, secondary to respiratory distress. Finally, the plates were fashioned into an inverted U and placed outside the trachea. In 67% of the subjects, the distraction was maintained and growth continued for the duration of the study. The stent was completely absorbed, with minimal scar or granulation tissue, in 4 months. In 1 subject, the stent migrated, and 1 subject died of a mucous plug. This study suggests that Lactosorb has no role in intraluminal stenting, but that it may be a viable alternative to a pericardial patch or cartilage in tracheal reconstruction when it is placed outside the airway lumen in a young animal.
Pearson
S E
SE
Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis 55455, USA.
Rimell
F
F
Stelow
E B
EB
Pernell
K
K
D020341:Absorbable Implants; D000818:Animals; D001672:Biocompatible Materials; D020007:Implants, Experimental; D019344:Lactic Acid; D011100:Polyglycolic Acid; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods; D015607:Stents; D013552:Swine; D013556:Swine, Miniature; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*
D001672:Biocompatible Materials; D011108:Polymers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid