Experiments Of Tracheal Reconstruction Using Porous Titanium Rings And Free Skin Flaps

Objective To investigate the feasibility and efficacy of the cervical tracheal reconstruction using porous titanium rings and free skin flaps.Methods Twelve adult mongrel dogs were divided randomly into groupâ… and groupâ…¡.A segment of cervical trachea (25mm, 4 rings,about 2/3 circumference)was resected and a rectangular free skin flap was harvested from abdomen.The flap was sutured to the defect part and supported with two porous titanium rings(groupâ… ) or without(groupâ…¡).X-ray and fiberscopic examinations were performed at the end of the first and the sixth month postoperatively.After six months the dogs were sacrificed and the grafts were examined macroscopically and microscopically.Results In groupâ… ,one dog was sacrificed for wound infection and skin flap necrosis with defluxion of titanium rings in the fifth day postoperatively.The other 5 of 6 survived until the end of six months.X-ray examinations showed titanium rings were fastened well without displacement or deformity.Through fiberscopy, the trachea luminal patency was maintained well without stricture,shrinkage or necrosis.Histologic examinations showed most of the inner surface of the flap was covered with ciliated columnar epithelium.In groupâ…¡,3 of 6 died of suffocation within 24 hours postoperatively.The remanent 3 of 6 survived from 7 to 16 days with dyspnea and fiberscopic examinations showed narrow trachea lumens.Conclusions Porous titanium rings could recreate the framework for cervical tracheal reconstruction using free skin flaps and would be one of the options for tracheal reconstruction.