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Tracheal Replacement in Rabbits with a New Composite Silicone-Metallic Prosthesis

Divisions of Cardiothoracic Surgery and
¹ Department of Pathology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
² Center for Biomaterials Research, Maastricht, The Netherlands
³ Experimental Surgery, Academic Medical Center, University of Amsterdam, The Netherlands

For reprint information contact: Ali Dodge-Khatami, MD Tel: 41 1 255 1111 Fax: 31 20 696 2289 email: a.dodgekhatami{at}amc.uva.nl Clinic of Cardiovascular Surgery, University Hospital Zurich, Ramistrasse 100, CH-8091, Zurich, Switzerland.

A new composite silicone-metallic prosthesis was tested, studying the potential for respiratory epithelial covering over the biocompatible inner lining, in a rabbit survival model. Seven New Zealand White rabbits underwent near-total excision of their trachea and implantation of a sterile prosthesis. After 2 months, they were sacrificed and the prostheses were retrieved. Specimens were fixed and histologically examined for tissue reaction around the prosthesis, at the anastomotic lines, and particularly for the presence or absence of epithelialization of the inner lumen over the biocompatible surface. All rabbits survived the operation. At 2 months, the outer layer of the prosthesis was consistently covered with fibrosis and neutrophils. The inner layer showed necrotic cells and scant re-epithelialization over the biocompatible lining, up to 5 mm beyond the anastomosis, with no evidence of organized respiratory epithelium in the middle sections. The new prosthesis is a viable temporary solution for airway replacement in rabbits. Granulation tissue was not observed at the anastomosis, and re-epithelialization did occur, but failed to achieve full-length luminal covering. The potential for granulation tissue does not yet make this an ideal long-term solution. Improvements in prosthesis design or biocompatibility are required, and need to be re-evaluated before applicability for chronic use.

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