University of Tasmania
whole_CohenRalphClinton1988_thesis.pdf (4.39 MB)

The development of a new tracheal stenosis model in piglets and its repair with a free periosteal graft

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posted on 2023-05-27, 08:29 authored by Cohen, Ralph C(Ralph Clinton)
Airway narrowing in-children from congenital stenosis or acquired stricture remains a difficult and challenging surgical problem. When the segment of tracheal stenosis is short, the best surgical treatment is to excise the stenosis and perform a primary end-to-end anastomosis. When there is an extensive segment of tracheal stenosis, this is clearly not possible and another means of enlarging the airway has to be devised. An appealing technique is to incise the stenotic segment longitudinally throughout its length, insert an endotracheal stent and then repair the resultant defect in the trachea with a suitable graft material. In this series of experiments, this technique is.examined in the thoracic segment of the piglet trachea. The study is performed in two phases. The initial experiments involve the normal trachea in which a, window defect is created over the entire length of the thoracic trachea involving 30% of its circumference. This defect represents that which would result when a stenotic segment of trachea is incised longitudinally. The window defect is then repaired with a free tibial periosteal graft. In the second phase, a model of tracheal stenosis is created by encircling the thoracic trachea with a silastic sheet. Once respiratory distress is established, the silastic sheet is removed at a second operation, and the stenotic segment incised, an endotracheal silastic stent inserted through the defect and the defect repaired with free tibial periosteal graft. The pigs are sacrified three months later when they have grown to about six times their original weight and the trachea removed. These studies demonstrate that free tibial periosteal grafts are an ideal biological material for repairing tracheal defects. The periosteum forms bone in a short period of time and supports the airway; the lumenal surface is lined with columnar and respiratory epithelium. This model suggests that tracheal stenosis in children may be surgically corrected by simply incising the stenotic segment longitudinally and enlarging the tracheal diameter by inserting a free periosteal graft into the defect.


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Copyright 1998 the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s). Thesis (M.S.)--University of Tasmania, 1988. Bibliography: p. 41-45

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