Kawanabe Yasuyo, Nagata Satoru
Department of Reconstructive Plastic Surgery, Akiba Hospital, Saitama City, Japan.
Plast Reconstr Surg. 2006 May;117(6):2011-8. doi: 10.1097/01.prs.0000210015.28620.1c.
The occurrence of chest wall deformity is not dependent on the amount of costal cartilage harvested but results from the method of costal cartilage harvest. Therefore, the authors developed a new method of costal cartilage harvest where the perichondrium is left completely intact at the donor site and the remaining costal cartilage after fabrication of the three-dimensional costal cartilage framework is returned to the perichondrial pocket to fill the dead space formed. By leaving the perichondrium completely intact, the most ideal environmental condition for regeneration of cartilage is attained.
The costal cartilages are harvested en bloc with the perichondrium left completely intact at the donor site. After fabrication of the three-dimensional frame, the remaining costal cartilage is cut into small blocks that act as spacers to fill the dead space formed in the perichondrial pocket.
The findings of the authors' study involving over 270 cases performed with the new method of costal cartilage harvest revealed that there were absolutely no postoperative chest wall deformities identified, and there was a significant decrease in intraoperative complications.
The authors' study revealed that the new method of costal cartilage harvest plays an important role in the regeneration of cartilage and in the prevention and avoidance of postoperative chest wall deformity.
胸壁畸形的发生并非取决于肋软骨的获取量，而是源于肋软骨的获取方法。因此，作者研发了一种新的肋软骨获取方法，即在供区完全保留软骨膜，并且在制作三维肋软骨框架后，将剩余的肋软骨放回软骨膜袋以填充形成的死腔。通过完全保留软骨膜，可实现软骨再生的最理想环境条件。
在供区将肋软骨整块获取，同时完全保留软骨膜。制作三维框架后，将剩余的肋软骨切成小块作为间隔物，以填充软骨膜袋中形成的死腔。
作者采用新的肋软骨获取方法进行的涉及270余例病例的研究结果显示，术后未发现胸壁畸形，术中并发症显著减少。
作者的研究表明，新的肋软骨获取方法在软骨再生以及预防和避免术后胸壁畸形方面发挥着重要作用。
