Kaschke O, Gerhardt H J, Böhm K, Wenzel M, Planck H
Hals-Nasen-Ohrenklinik, Universitätsklinikum Charité Berlin.
HNO. 1995 Feb;43(2):80-8.
Extensive tracheal defects after prolonged assisted ventilation, trauma or large resections in tumor surgery are a challenge in plastic and reconstructive surgery. Defects which cannot be satisfactorily repaired reguine near of an alloplastic tracheal replacement. Previous experimental and clinical experiences in the development of an alloplastic tracheal prosthesis have demonstrated that the main cause for failure is the lack of an epithelial lining of luminal surfaces and inadequate biophysical properties of the prosthesis. With the use of a cell-seeding technique tested in vitro on biomaterials epithelialization of tracheal prostheses can be tested in vivo. In animal experiments isolated respiratory cells were seeded into implanted tubular prostheses of porous polyurethane or expanded polytetrafluorethylene. Light and scanning microscopic investigations then showed the tendency of epithelialization to occur on the luminal surfaces. Vigorous squamous epithelium cell layers that were single and (predominantly) multiple layers were found. Differentiated cilated or mucous cells were not detected in any case. The present results have shown that epithelialization of incorporated porous implants is possible. The realization of usable tracheal replacement for clinical practice must still be tested in further experiments.
在长期辅助通气、创伤或肿瘤手术中的大面积切除后出现的广泛气管缺损，是整形和重建外科面临的一项挑战。无法得到满意修复的缺损需要一种异体气管替代物。以往在开发异体气管假体方面的实验和临床经验表明，失败的主要原因是管腔表面缺乏上皮内衬以及假体的生物物理性能不足。通过在生物材料上进行体外测试的细胞接种技术，可以在体内测试气管假体的上皮化情况。在动物实验中，将分离出的呼吸细胞接种到植入的多孔聚氨酯或膨体聚四氟乙烯管状假体中。随后的光镜和扫描电镜研究显示，管腔表面有上皮化的趋势。发现了单层和（主要是）多层的活跃鳞状上皮细胞层。在任何情况下均未检测到分化的纤毛细胞或黏液细胞。目前的结果表明，植入的多孔植入物实现上皮化是可能的。临床可用气管替代物的实现仍需在进一步实验中进行测试。
