Trachea Reconstruction with Single-Stage Composite Flaps in a Rabbit Model.

Area of Science:

• Regenerative Medicine
• Biomaterials Science
• Surgical Innovation

Background:

• Trachea reconstruction demands a functional lining, rigid support, and vascular supply.
• Current methods face challenges in achieving all three essential components simultaneously.

Purpose of the Study:

• To design and evaluate composite autologous flaps for single-stage trachea reconstruction.
• To assess the efficacy of different flap components (skin, cartilage, muscle) in a rabbit model.

Main Methods:

• Two composite flap techniques were tested in rabbits with circumferential and partial anterior tracheal defects.
• Ear composite flaps (cartilage and skin) and rib cartilage with intercostal muscle flaps were utilized.
• Flaps were assessed for integration, vascularity, and epithelialization via clinical, endoscopic, and histological examination.

Main Results:

• Ear flaps provided vascularized cartilage but led to airway obstruction due to skin issues.
• Rib cartilage and intercostal muscle flaps resulted in complete survival without respiratory distress.
• The intercostal muscle fascia was successfully covered by native respiratory epithelium.

Conclusions:

• Autologous composite flaps offer a viable strategy for single-stage trachea reconstruction.
• Vascularized muscle fascia is a superior lining material compared to skin for tracheal defects.
• Rib cartilage and muscle flaps show promise for reconstructing partial tracheal defects in humans.