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Multilayer costal grafts to prevent cartilage deformation: an experimental study

  • Experimental Study
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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Cartilage grafting is a common procedure in nasal reconstruction or dorsal augmentation. Costal cartilage is usually preferred to conchal or septal cartilage when a larger amount of graft is required, although this cartilage type is often complicated by postoperative warping. To overcome this complication, we suggest the use of multilayer costal grafts. This study aims to compare single-layer and multilayer costal grafts concerning angle of warpage, cartilage viability, and architectural changes in the animal model.

Methods

Twelve costal grafts were harvested from a fresh Landrace pig cadaver; six were shaped in single-layer grafts and six into a multilayer structure, both having the same thickness. These grafts were implanted in subcutaneous dorsal skin pockets of six athymic nude rats. After 8 weeks, the animals were euthanized and the grafts removed. Pictures of the cartilages were acquired. The samples were processed and stained for histological (hematoxylin and eosin, Alcian blue, Von Kossa, Masson-Goldner trichrome, and Verhoeff/Van Gieson stains) and immunohistochemical (GFAP) analyses.

Results

A higher grade of deformation was observed in the single-layer group compared to the multilayer one (5.2° vs 0.3°). Multilayer cartilage showed significantly higher chondrocyte density (70.4 vs 44.9 cells per field at 40×) and the lowest loss of nuclei in chondrocyte lacunae percentage (0.03 vs 3.2 %). Single-layer grafts also showed sporadic inflammatory cell infiltration, not found in multilayer ones.

Conclusions

Multilayer grafts showed a decreased degree of warping as well as an increased viability and should be considered as a valuable alternative in nasal reconstruction.

Level of evidence: Not ratable

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Via Galeazzi 4, 20161, Milan, Italy

    Giovanni Ravasio

  2. Plastic Surgery Department, IRCCS Istituto Ortopedico Galeazzi, Università degli Studi di Milano, Via Galeazzi 4, 20161, Milan, Italy

    Riccardo Gazzola, Giuseppe Cottone, Luciano Lanfranchi & Franz Wilhelm Baruffaldi Preis

Authors
  1. Giovanni Ravasio
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  2. Riccardo Gazzola
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  3. Giuseppe Cottone
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  4. Luciano Lanfranchi
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  5. Franz Wilhelm Baruffaldi Preis
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Corresponding author

Correspondence to Riccardo Gazzola.

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Ethical standard

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

Conflict of interest

Giovanni Ravasio, Riccardo Gazzola, Giuseppe Cottone, Luciano Lanfranchi, and Franz Wilhelm Baruffaldi Preis declare they have no conflict of interest.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Ravasio, G., Gazzola, R., Cottone, G. et al. Multilayer costal grafts to prevent cartilage deformation: an experimental study. Eur J Plast Surg 39, 401–408 (2016). https://doi.org/10.1007/s00238-016-1224-4

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  • DOI: https://doi.org/10.1007/s00238-016-1224-4

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