SIS with tissue-cultured allogenic cartilages patch tracheoplasty in a rabbit model for tracheal defect.
CONCLUSIONS
In the rabbit model, small intestinal submucosa (SIS) compounded with tissue-cultured allogenic cartilages appeared to be an efficacious method for the patch repair of partial circumferential tracheal defects instead of autologous grafts. SIS appears to be a safe and promising means of facilitating neovascularization and tissue regeneration. The long-term use of SIS and tissue-cultured allogenic cartilages warrants further investigation.


BACKGROUND
Tracheal defect reparation remains a challenging surgical problem that can require reconstruction using autologous grafts or artificial stents. This study was performed to evaluate the efficacy of SIS, a biocompatible, acellular matrix, compounded with different tissue-cultured allogenic cartilages, in the repair of a critical-size tracheal defect.


METHODS
A full-thickness defect (4 x 8 mm) was created in tracheal rings four to six in adult rabbits. A piece of 8-ply SIS sandwiched in thyroid cartilage, auricular cartilage, or without cartilage, respectively (designated experiment 1, 2, or 3, respectively), was sutured to the edges of the defect with interrupted 4-0 polypropylene sutures. In control animals, the defect was closed with lamina praetrachealis. All animals were followed until signs of dyspnea became apparent or for 4 or 12 weeks. After follow-up and euthanasia, the trachea was harvested and prepared for histologic evaluation using conventional techniques.


RESULTS
All animals tolerated the procedure well but two animals in group 1 (n=5), three in group 2 (n=5), and one in group 3 (n=5) had stridor after operation and expired within <1 month with different degrees of obstruction. The other animals in these groups and the control animals (n =3) all survived >1 month. Histologically, neovascularization of the patch was noted with moderate inflammation. The surface of the SIS patch was covered with a lining of ciliated epithelial cells. The tissue-cultured allogenic cartilages degraded to some extent.
Zhang
Longfang
L
Department of Otolaryngology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China. zhlf2006@163.com
Liu
Zhi
Z
Cui
Pengcheng
P
Zhao
Daqing
D
Chen
Wenxian
W
D000818:Animals; D002356:Cartilage / Q000637:transplantation*; D007413:Intestinal Mucosa / Q000166:cytology / Q000637:transplantation*; D007421:Intestine, Small / Q000166:cytology / Q000637:transplantation*; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D046509:Tissue Culture Techniques; D014135:Tracheal Stenosis / Q000601:surgery*; D014184:Transplantation, Homologous