ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
An enhanced method of rapid cartilage healing after costal cartilage resection
Arif Osman Tokat1, Eren Taştan2, Sezgin Karasu1, Orhan Yücel3, Mehmet Gamsızkan4, Sıddık Arslan5, Oğuz Kılıçkaya6, Onur Genç3
1Department of Thoracic Surgery, Ankara Training and Research Hospital, Ankara, Turkey
2Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey
3Department of Thoracic Surgery, Gülhane Military Medical Faculty, Ankara, Turkey
4Department of Pathology, Ankara Mevki Military Hospital, Ankara, Turkey
5Department of Statistics, Faculty of Tourism and Commerce, Gazi University, Ankara, Turkey
6Department of Anesthesiology and Reanimation, Gülhane Military Medical Faculty, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2012.060
Background: In this study we aimed to compare the effects of leaving the perichondrial sheaths open, closing the sheaths reciprocally, and leaving the resected cartilages in the perichondrial bed as small autologous grafts to clarify the effect of perichondrium left intact within the donor site on costal cartilage regeneration.

Methods: In this study, eight domestic pigs (Sus Scrofa Domestica) with a mean age of six months were used. Following resection of the sixth and seventh costal cartilages, costal cartilage beds were assigned to three groups. In group 1, perichondrial sheaths were left open, while muscles and other layers were closed. In group 2, perichondrial sheaths were reciprocally sutured with a soluble material. In group 3, grafts of 3 mm cubes, prepared from the resected costal cartilages of each subject, were located in the perichondrial beds and closed.

Results: Costal cartilage regenerations in all three groups were scored and compared. Statistically significant differences were found among the groups (chi-square= 20.227, p<0.001). Group 1 had the lowest median score, compared to the other groups with a statistically significant difference. In group 3, the examination revealed that chondrocytes of newly developing fibrous cartilage were found to penetrate towards the cartilages located inside in seven of 20 preparations.

Conclusion: This study shows that autologous cartilage pieces left in the perichondrial space accelerate cartilage regeneration and lead to spontaneous self-oriented chondrocyte migration, contributing to the stability of thoracic wall.

Keywords : Autologous graft; costal cartilage; perichondrium
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