Experimental study of a new tracheal prosthesis made from collagen-grafted mesh

The efficiency of a new tracheal prosthesis was studied. The prosthesis consists of fine Marlex mesh reinforced with a continuous Teflon spiral, and it is grafted and coated with pig collagen, with the aim of promoting connective tissue infiltration and providing air-tightness during the initial stage of implantation. Complete surgical resection and replacement of a 4-6 tracheal ring segment of the cervical trachea was performed in 13 adult mongrel dogs. Except for two dogs that developed anastomotic insufficiency, the prostheses in all dogs were infiltrated by the surrounding connective tissue, and were completely incorporated by the host trachea at the anastomotic sites. Formation of respiratory epithelium that lined the prosthesis lumen, was seen to varying degrees, and in one dog killed at 4 months after reconstruction, this was confirmed histologically from the upper to the lower anastomosis of the prosthesis. Stenosis of the lumen often occurred, however, due to deformation of the prosthesis and overgrowth of granulation tissue. The authors conclude that this tracheal prosthesis is highly biocompatible, and might be useful for repairing tracheal defects by improving prosthesis processing, especially that used for insertion of stents.