Huang Hui-Fu, Hwang Juey-Jen, Huang Pei-Ming
Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan.
JTCVS Tech. 2021 Oct 19;10:554-560. doi: 10.1016/j.xjtc.2021.10.032. eCollection 2021 Dec.
The replacement of tracheal defects has been a challenge for investigators worldwide. We aimed to develop autologous nail grafts for the reconstruction of anterior tracheal defects.
Toenail grafts were implanted to improve the structural integrity of the trachea in patients with tracheal diseases. We clinically applied these grafts for the partial replacement of the cervical tracheal cartilage. Data on graft construction details, clinical outcomes, bronchoscopy, and 3-dimensional computed tomography examinations were collected.
The nail grafts were implanted in 4 patients. The trachea was successfully reconstructed in all cases. Bronchoscopy was performed 3 times to document healing: immediately, 1 month, and 3 months after surgery. All grafts were well vascularized and incorporated into the tracheal wall and were covered with the respiratory mucosa. Three of the patients survived during the study period, but 1 patient died of progressive lung cancer.
Toenail grafts potentially may be used as an alternative strategy for the closure of small defects during tracheal reconstruction.
气管缺损的修复一直是全球研究者面临的一项挑战。我们旨在开发用于重建气管前部缺损的自体指甲移植物。
将趾甲移植物植入气管疾病患者体内以改善气管的结构完整性。我们将这些移植物临床应用于颈段气管软骨的部分置换。收集了移植物构建细节、临床结果、支气管镜检查和三维计算机断层扫描检查的数据。
4例患者植入了趾甲移植物。所有病例气管均成功重建。术后即刻、1个月和3个月进行了3次支气管镜检查以记录愈合情况。所有移植物均血运良好，融入气管壁并被呼吸道黏膜覆盖。研究期间3例患者存活，但1例患者死于进展期肺癌。
趾甲移植物可能可用作气管重建过程中闭合小缺损的替代策略。
