Prefabrication of a free flap for tracheal reconstruction: An experimental study. Preliminary report

被引:15
作者
Cavadas, PC
Bonanad, E
BaenaMontilla, P
VeraSempere, FJ
机构
[1] HOSP LA FE, DEPT PLAST SURG, E-46009 VALENCIA, SPAIN
[2] HOSP LA FE, DEPT PATHOL, E-46009 VALENCIA, SPAIN
关键词
D O I
10.1097/00006534-199611000-00020
中图分类号
R61 [外科手术学];
学科分类号
摘要
The development of a prefabricated free flap that could have potential for tracheal reconstruction has been investigated in the goat model. Through a staged procedure, a composite cutaneous-chondromucosal premolded, prevascularized flap was obtained by prefabrication techniques. The procedure comprised three surgical stages. In the first stage, on day 0, die cartilaginous framework was constructed, along with the vascular pedicle (implantation of an arteriovenous fistula as a vascular carrier). In the second stage, on day 50, the inner surface of the neotrachea was lined with nasal mucosa. In the third stage, on day 60, the flap was elevated and free transferred to reconstruct a 15-cm circumferential defect in the cervical trachea. Ten animals were operated on, and the results were one infection, three early deaths, one free-flap failure with early tracheal stenosis, and five long-term survivors without significant stenosis. The structure of the neotracheal flap closely resembled that of the native trachea: internal respiratory epithelial lining, cartilage rings, and fibrovascular tissue. Fiberoptic bronchoscopy was done to all the animals at 10 and 60 days revealing no significant stenosis in the long-term survivors.
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页码:1052 / 1062
页数:11
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