Microsurgical reconstruction of the trachea in rats (an experimental study)

This study was carried out to evaluate the use of 'Zenoderm' (enzyme treated procine dermis) as a patch for the repair of tracheal defects in rats, with particular reference to its application in the treatment of some cases of tracheal stenosis. Fifty-three rats were included in the study. Using microsurgical techniques, a defect was created in the cervical trachea and repaired using a suitable patch of 'Zenoderm' (two groups with different sized defects). In a further group of rats, healing of the trachea was studied after excision of a segment and end to end anastomosis. A set number of rats were sacrificed after intervals of 14, 28, 91 and 182 days when the trachea was excised and evaluated. Healing of the tracheae following end to end anastomosis was satisfactory in all cases with no evidence of stenosis. The two groups of tracheae with Zenoderm patches showed progressive stenosis at the area of the repair but there was no evidence of respiratory obstruction or distress. The Zenoderm patch and the regenerating epithelium were both evaluated by light microscopy and scanning electromicroscopy. The Zenoderm patch showed gradual absorption and was replaced by host collagen. There was gradual regeneration of epithelium which showed slow maturation from flat non-ciliated epithelium to partially cuboidal and columnar epithelium with some cilia showing early differentiation to respiratory epithelium. In conclusion, this experimental study confirmed the biocompatibility of 'Zenoderm' in rats. It provided a suitable surface for regeneration of tracheal epithelium. Replacement of the patch by the host collagen is promising but requires further study to assess its rigidity and ability to withstand pressure changes in the trachea.