What wrapped perichondrial and periosteal grafts offer as regenerators of new tissue |
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Authors: | Sari Alper Tuncer Serhan Ayhan Suhan Elmas Cigdem Ozogul Candan Latifoglu Osman |
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Affiliation: | Departments of Plastic, Reconstructive and Aesthetic Surgery, Gazi University Medical Faculty, Ankara, Turkey. alpersari@mersin.edu.tr |
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Abstract: | The major goals in contour restoration procedures are to re-establish the desired contour with the use of resilient and durable materials that can be easily found and harvested. Cartilage grafts are commonly used for these purposes though they often possess a problem of donor site morbidity and shortage of quantity. The neo-cartilage formation capacities of both perichondrium and periosteum are well-known. We aimed to optimize both the amount and quality of the newly forming tissue from perichondrial and periosteal grafts. For this purpose the grafts were wrapped on themselves. Placement of oxidized regenerated cellulose (ORC) within graft layers was performed in two groups with the aim of giving support to the regenerating tissue, and increasing the connective tissue formation within the graft layers. Three-month-old New Zealand white rabbits were used. Group 1 ear perichondrial, and Group 2 calvarium periosteal grafts of 1.4 x 2.4 cm were harvested, folded on themselves, and sutured at the edges to create closed pockets. 0.8 x 0.8 cm sized ORC sheets were placed inside the pockets before wrapping in Group 3 perichondrial and Group 4 periosteal grafts. 0.2-mL autogenous blood was injected in each pocket. All grafts were transplanted under the abdominal muscle fascia, and harvested after 6 weeks. Volumes and weights of wrapped perichondrial grafts were higher than their periosteal counterparts either with or without the inclusion of ORC. Grafts with ORC (Groups 3 and 4) were heavier than the grafts lacking ORC (Groups 1 and 2), in a statistically significant manner (P = 0.01). Histologically, the inclusion of ORC in both perichondrial and periosteal grafts resulted in an increased amount of fibrosis, yet did not preclude neo-cartilage formation. |
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