title: Costal cartilage graft with perichondrium, a possible anti-adhesive material.
abstract: BACKGROUND
  Adhesion occurs as a part of the wound healing process, but it sometimes compromises patients' daily activities. The authors were looking for materials and methods that could prevent adhesion, and noticed that the costal cartilage has possibility. The anti-adhesive property of the costal cartilage was examined histologically.
  
  
  METHODS
  Thirty-five patients with microtia who provided consent for participating in this study were enrolled between April 2008 and March 2015. In the first stage of microtia reconstruction surgery, the excess cartilage was used to create these three types of specimens: (A) a piece of cartilage retaining the perichondrium on one side, (B) a piece of only cartilage parenchyma sliced with a plane parallel to the long axis of costal cartilage, and (C) the costal cartilage in a plane perpendicular to the long axis sliced pieces. These specimens were implanted into the subcutaneous fat of the chest. After at least 6 months in the second stage of surgery (i.e. auricular elevation), these specimens, wearing a little around the adipose tissue, we removed and examined histologically.
  
  
  RESULTS
  A fibrosis formation of the perichondrium side of Specimen A was thicker significantly than that of the cartilage side. A fibrosis formation of Specimen B was thicker significantly than that of the cartilage side of Specimen A.
  
  
  CONCLUSIONS
  It was suggested that, if there is perichondrium, the costal cartilage parenchyma surface makes less adhesion with surrounding tissues. Costal cartilage with unilateral perichondrium is likely to be an effective surgical material for adhesion prevention.
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Fukuda
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Asato
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Umekawa
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Goro
authors.initials: G
authors.lastname: Takada
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kan
authors.affiliation: a Department of Plastic and Reconstructive Surgery , Dokkyo Medical University , Tochigi , Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle; D002648:Child; D015331:Cohort Studies; D065817:Congenital Microtia / Q000601:surgery*; D066186:Costal Cartilage / Q000473:pathology* / Q000637:transplantation*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000517:prevention & control*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
keywords: Costal cartilage; adhesion; anti-adhesive material; microtia; perichondrium