Comparison of different methods of circumferential tracheal reconstruction: an experimental study.
OBJECTIVE
This study was designed to compare different prefabrication models for circumferential tracheal reconstruction.


METHODS
Thirty adult female New Zealand rabbits were divided into six groups for circumferential tracheal reconstruction with a different tissue combination. Prefabrication of neotrachea was performed without anastomosis. Lateral thoracic fascia or pectoralis major muscle were used for vascular supply. Polypropylene mesh, polytetrafluoroethylene (Gore-Tex), or cartilage rings were used for skeletal framework. Hairless epithelial skin graft was used for inner lining. The groups were compared in terms of viability of hairless epithelial graft, longitudinal flexibility, rigidity, flap wall thickness, internal diameter, and flap viability.


RESULTS
Epithelial skin graft was almost totally viable (95%-99%) in the polypropylene mesh groups. Gore-Tex groups exhibited almost total necrosis (74%-71%). Longitudinal flexibility and rigidity were similar to the native trachea in Gore-Tex and polypropylene mesh groups. Neotrachea prefabricated with cartilage grafts showed more than normal longitudinal flexibility and collapsed easily.


CONCLUSIONS
The prefabricated model with the use of polypropylene mesh for skeletal framework and lateral thoracic fascia for vascular supply seems to be the best alternative in the reconstruction of circumferential tracheal defects.
Okumuş
Ayhan
A
Department of Plastic and Reconstructive Surgery, Medical Faculty of Istanbul University, Istanbul, Turkey. aokumus@asg.com.tr
Cizmeci
Orhan
O
Kuvat
Samet V
SV
Kabakaş
Fatih
F
Aslanov
Ayaz
A
Yaprak
Bülent
B
Güven
Erdem
E
Hafiz
Günter
G
D000818:Animals; D004195:Disease Models, Animal; D004425:Ear Cartilage / Q000637:transplantation; D005260:Female; D011817:Rabbits; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013526:Surgical Mesh; D014132:Trachea / Q000098:blood supply / Q000293:injuries* / Q000601:surgery*