The effectiveness of hyperbaric oxygen treatment in tracheal reconstruction with auricular cartilage grafts (experimental study).
OBJECTIVE
Tracheal stenosis or neoplastic changes, as well as, traumatic, congenital, or iatrogenic causes may require extensive tracheal resections. Complications like vascularization insufficiency and structural support problems occur nearly in all cases when end-to-end anastomosis of trachea is not feasible. Hyperbaric oxygen (HBO) treatment is a well-known method for the management of grafts and flaps that have vascularization problems. In this study, the effect of hyperbaric oxygen treatment on wound healing after tracheal reconstruction with auricular cartilage graft (ACG) has been evaluated.


METHODS
Thirty-two rabbits were divided into 2 groups: study group (n = 16) and control group (n = 16). The anterior halves of the six tracheal rings were resected, and the defects were repaired with autogenic auricular grafts. Hyperbaric 100% pure oxygen was administered to the study group at 2.4 atmospheres of absolute pressure 2 times a day for 1 week. The control group did not receive any therapy except proper control of the wound.


RESULTS
It was observed that in the study group, inflammation, fibrosis, and necrosis were less, whereas epithelialization and maturation were early and neovascularization and neochondrification were more than the control group only at specific weeks. But all tracheas in both groups showed excellent healing without graft rejection and excessive granulation tissue formation. Furthermore, there was no statistically difference between the 2 groups.


CONCLUSIONS
Auricular cartilage grafts is a valuable management method of tracheal defects, and hyperbaric oxygen treatment is a good supplementary method in healing period of cartilage autografts.
Gungor
Atila
A
Department of ENT, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey. atilagungor@superonline.com
Poyrazoglu
Ethem
E
Cincik
Hakan
H
Sali
Murat
M
Candan
Hasan
H
Ay
Hakan
H
D000818:Animals; D002356:Cartilage / Q000637:transplantation*; D006085:Graft Survival; D006931:Hyperbaric Oxygenation / Q000379:methods; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology