Motamed Sadrollah, Mohammadi Torbati Peyman, Zaferani Arani Hamid, Motabar Amir Reza, Zabolian Amirhossein, Madadi Zahra
Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
World J Plast Surg. 2019 May;8(2):219-228. doi: 10.29252/wjps.8.2.219.
Cartilage grafts are generally accepted for the restoration and reconstruction of nasal contours. The main concern that plastic surgeons may need to address after surgery pertains to the resorption and disfigurement of the grafted cartilage, especially in allogenic and heterogenic grafts.
A total of 12 white rabbits were divided into three groups according to the types of graft including autograft, allograft, and heterograft. We used three shapes of grafts, including block, crushed, and diced cartilage in the upper, middle, and lower rows. However, in each rabbit, these grafts were divided into two columns of wrapped and unwrapped grafts, with human amniotic membrane (HAM) grafted on each side of the rabbit's back.
In total, 60 specimens underwent histopathological examination. No inflammation was observed in about 50% of the block-shaped conchal cartilages with HAM, and in 50%, less than 25 inflammatory cells per unit were seen. The prognosis and absorption of autograft specimens in block-shaped cartilages with HAM were significantly better compared with other shapes of cartilages with HAM and without HAM. The proliferation rate of fibroblasts in autograft and allograft specimens was more than that in heterograft specimens with HAM.
Our findings have demonstrated the new role of HAM in clinical applications, indicating that HAM may be used as a low-cost, easily accessible alternative for wrapping in cartilage grafts instead of fascia or surgicel in early future. It is useful for improving the long-term outcomes and decreasing the resorption rate.
软骨移植通常被用于鼻轮廓的修复与重建。整形外科医生术后可能需要关注的主要问题与移植软骨的吸收和变形有关，尤其是在同种异体和异种移植中。
根据移植类型，将12只白兔分为三组，包括自体移植、同种异体移植和异种移植。我们使用了三种形状的移植物，分别是块状、粉碎状和切碎状软骨，分布在上、中、下排。然而，在每只兔子身上，这些移植物被分为包裹和未包裹两组，在兔子背部两侧移植人羊膜（HAM）。
总共60个标本接受了组织病理学检查。在约50%带有HAM的块状耳甲软骨中未观察到炎症，50%的标本中每单位可见少于25个炎性细胞。与其他形状的带有和不带有HAM的软骨相比，带有HAM的块状软骨中自体移植标本的预后和吸收情况明显更好。带有HAM的自体移植和同种异体移植标本中成纤维细胞的增殖率高于异种移植标本。
我们的研究结果证明了HAM在临床应用中的新作用，表明在不久的将来，HAM可能作为一种低成本、易于获取的替代品，用于包裹软骨移植物，而不是筋膜或外科用纱布。它有助于改善长期效果并降低吸收率。
