A new tracheal prosthesis made from collagen grafted mesh

Area of Science:

• Biomaterials Science
• Surgical Innovation
• Veterinary Medicine

Background:

• Tracheal defects pose significant challenges in surgical reconstruction.
• Existing prostheses often face issues with biocompatibility and integration.
• A need exists for advanced tracheal prostheses with improved host tissue interaction.

Purpose of the Study:

• To evaluate the efficacy and biocompatibility of a new Marlex mesh tracheal prosthesis.
• To assess the integration and healing of the prosthesis in a canine model.
• To determine the potential for clinical application in tracheal reconstruction.

Main Methods:

• A 50 mm long, 18-22 mm diameter Marlex mesh tracheal prosthesis, reinforced with polypropylene and coated with porcine collagen, was implanted in 20 dogs.
• Surgical resection and replacement of a 7-9 ring cervical tracheal segment was performed.
• A temporary silicone tube facilitated secretions, removed after 1 month via fiber bronchoscopy.

Main Results:

• 17 of 20 prostheses were successfully infiltrated by connective tissue and incorporated by host tissue.
• Significant luminal stenosis occurred in one dog, leading to suffocation; mild stenosis occurred in eight dogs due to granulation tissue.
• Histological analysis confirmed varying degrees of respiratory epithelium coverage, with confluent epithelization in one case at 22 months.

Conclusions:

• The Marlex mesh tracheal prosthesis exhibits high biocompatibility and promotes host tissue integration.
• The prosthesis demonstrates potential for successful tracheal reconstruction, warranting further clinical investigation.
• Porcine collagen coating enhances biocompatibility and provides an initial airtight seal.