Esterified hyaluronic acid improves cartilage viability in experimental tracheal reconstruction with an auricular graft.
OBJECTIVE
The aim of this study was to determine the efficacy of esterified hyaluronic acid (HYAFF) on the vitality of auricular cartilage grafts used for tracheoplasty, with respect to macroscopic and microscopic parameters.


METHODS
Prospective, controlled.


METHODS
Academic research laboratory.


METHODS
The study included 14 New Zealand rabbits acquired specifically for the study. The rabbits were divided into two groups: the control group, in which free cartilage grafts were not exposed to any materials or additional procedures (n = 7), and the hyaluronic acid (HA) treatment group, in which auricular grafts and anastomosis lines were covered with HYAFF (n = 7). Free auricular cartilage grafts used for the reconstruction of experimentally created tracheal defects were anastomosed extraluminally. All the rabbits were sacrificed two months post surgery. Samples were collected and examined histopathologically. The sections were stained with hematoxylin-eosin, Masson's trichrome, and inducible nitric oxide synthase (iNOS) and examined under a light microscope.


RESULTS
Fibrosis and cartilage mass significantly differed between the control and HYAFF group (P < 0.05). Immunohistochemical examination showed that more chondrocytes stained with iNOS in the control group than in the HYAFF group, according to histologists' observations.


CONCLUSIONS
HYAFF catalyzed wound healing with less fibrous tissue formation, had chondroprotective and stimulatory effects on chondrocyte metabolism, and decreased nitric oxide production and apoptosis via improving the nourishment of free auricular cartilage grafts, subsequently preventing hypoxia and oxidative stress, particularly in the early postimplantation period.
Department of Pediatric Surgery, Mustafa Kemal University, Faculty of Medicine, Hatay, Turkey. aktemiz@yahoo.com
Abdulkerim
A
Temiz
K Cagdas
KC
Kazikdas
Bekir
B
Ergur
Kazim
K
Tugyan
Sahin
S
Bozok
Durdane
D
Kaya
Ensari
E
Guneli
D000818:Animals; D004195:Disease Models, Animal; D004425:Ear Cartilage / Q000187:drug effects*; D004951:Esterification; D006820:Hyaluronic Acid / Q000494:pharmacology*; D008297:Male; D011817:Rabbits; D019651:Plastic Surgery Procedures; D014022:Tissue Survival / Q000187:drug effects; D014132:Trachea / Q000293:injuries / Q000601:surgery*; D014945:Wound Healing / Q000187:drug effects
D006820:Hyaluronic Acid