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The 2003 Annual Meeting of OASYS_NEW |
Introduction
: Prefabrication and prelamination of flaps and tissue engineering provide an enriched armamentarium in difficult reconstructions. The current study employs these techniques to create a vascularized autogenous ear construct that is readily transferable on its own vascular pedicle.Methods: 15 male Wistar rats (250-350 gms) were anaesthetized. An incision was made
over the right lower abdominal wall. A pocket was formed by blunt dissection just below the panniculus carnosus. A separate incision was made over the right femoral vessels, which were then isolated and transected distally. The vessels were transposed in a subcutaneous plane to the abdominal wound. A silicone mold in the shape of an ear (2 cm by 1.5cm) was placed over the transposed vessels in the abdominal wound pocket. The mold and the vessels were secured with 6.0 vicryl sutures. Auricular cartilage was minced, washed and cultured using standard chondrocyte culturing techniques. After 14 days, the chondrocyte culturing was complete and a vascularized capsule based on the incorporated, transposed femoral vessels was formed. The abdominal incision was then reopened, an incision made in the lateral capsule and the cultured chondrocytes introduced into the molded capsule. Study groups included capsules filled with chrondrocytes only, chondrocytes and a fibrin glue carrier, and the fibrin glue only. The capsule was closed and the wounds sutured. The prefabricated, prelaminated construct was isolated on its vascular pedicle 14 days later. The pedicle was transected and the flap transferred to a heterotopic location and the vessels microsurgically anastomosed. Blood flow to the ear constructs was re-established. Histiologic analysis was performed.
Results: All of the 15 capsules were completely vascularized and could be reliably isolated on the transposed femoral vessels. The pedicle, being incorporated directly into the capsule, provided the dominant blood supply to the construct. None of the capsules with the fibrin glue only retained any shape and were devoid of cartilage. Similarly, there was no evidence of retained cartilage in the capsules filled with chondrocytes alone. All capsules with the chondrocytes and the fibrin carrier had mature shaped cartilage preservered.
Discussion: We have shown that transposing a vascular pedicle to a subcutaneously placed silicone block will result in a vascular capsule that can be mobilized and transferred based solely on the pedicle. While the capsule provides vascularity to the chondrocytes, the cultured cartilage will fill the shape of the silicone mold only if an appropriate carrier such as fibrin glue is employed.