Ohlsén L, Nordin U
Scand J Plast Reconstr Surg. 1976;10(2):135-45. doi: 10.3109/02844317609105201.
Since 1972 a series of experiments (Skoog, Ohlsén & Sohn, 1972; 1975; Ohlsén, 1976) has been performed to elucidate the potential of perichondrial grafts to generate cartilage. In 1974 Sohn & Ohlsén demonstrated in rabbits that tracheal cartilage could be reconstructed from free perichondrial grafts. As these studies were carried out with an intact tracheal mucosa a series of experiments was conducted in rabbits, and reported in this paper, in which a tracheal section containing two cartiliages and the covering mucous membrane was removed and replaced with a free perichondrial graft taken from the ear. New cartilege formed in all animals. The reconstructed portion of trachea was partly covered by ciliated cells of normal appearance, partly by low epithelium with microvilli. These latter areas were mainly within the central parts of the regenerated mucosa. The use of perichondrial grafts for tracheal reconstruction was also studied in two series of dogs. In four dogs a tracheal section, consisting of two comlete cartilages with the covering mucosa, was completely removed. The circumferential defect was reconstructed by free perichondrial grafats from rib cartilage. They were placed on two fascial flaps which had been raised from the adjacent muscles, rotated into the defect and sutured for complete coverage. Regeneration of cartilage occurred in all dogs, producing a biologic framework. The lining of the reconstructed tracheal section was completely restored by epithelialization from the surrounding mucosa. Low epithelial cells were successively replaced by columnar ciliated cells typical of the respiratory tract. The morphological development of the regenerated epithelium was demonstrated by electron microscopy. The regenerated mucosa exhibited normal function by passing mucus across the reconstructed area. This was recorded by filming at low speed using Cardio-green as indicator. All the animals of this series developed tracheal stenosis within the reconstructed portion. Another experiment was therefore carried out in which four dogs were subjected to the same operative procedure. Postoperatively, however, during the phase of healing, a silicon tube was inserted and left in situ to maintain expansion of the reconstructed portion. By this means stenosis could be prevented with good regeneration of the mucosal lining.
自1972年以来，已经进行了一系列实验（斯科格、奥尔森和索恩，1972年；1975年；奥尔森，1976年），以阐明软骨膜移植生成软骨的潜力。1974年，索恩和奥尔森在兔子身上证明，游离软骨膜移植可以重建气管软骨。由于这些研究是在完整的气管黏膜上进行的，因此在兔子身上进行了一系列实验，并在本文中进行了报道，实验中切除了包含两块软骨和覆盖黏膜的气管段，并用取自耳朵的游离软骨膜移植进行替换。所有动物都形成了新的软骨。气管重建部分部分被外观正常的纤毛细胞覆盖，部分被带有微绒毛的低柱状上皮覆盖。后一种区域主要位于再生黏膜的中央部分。还在两组狗身上研究了使用软骨膜移植进行气管重建。在四只狗身上，完全切除了由两块完整软骨和覆盖黏膜组成的气管段。环形缺损通过取自肋软骨的游离软骨膜移植进行重建。将它们放置在从相邻肌肉掀起的两块筋膜瓣上，旋转到缺损处并缝合以实现完全覆盖。所有狗都发生了软骨再生，形成了一个生物框架。重建气管段的内衬通过周围黏膜的上皮化完全恢复。低柱状上皮细胞逐渐被呼吸道典型的柱状纤毛细胞取代。通过电子显微镜观察了再生上皮的形态发育。再生黏膜通过使黏液穿过重建区域表现出正常功能。使用心绿作为指示剂，通过低速拍摄记录了这一过程。该组所有动物在重建部分均出现了气管狭窄。因此又进行了另一项实验，对四只狗进行了相同的手术操作。然而，术后在愈合阶段，插入一根硅胶管并留在原位以维持重建部分的扩张。通过这种方法，可以防止狭窄，黏膜内衬也能良好再生。
