New Technique for Laryngotracheal Mucosa Transplantation: 'Stamp' Welding Using Indocyanine Green Dye and Albumin Interaction With Diode Laser

Publisher Website
Google Scholar
Abstract
Objective: To investigate (1) the possibility of survival of free mucosa "stamp" grafts fixed in the airway with a new technique using indocyanine green—dyed albumin solder activated with a diode laser and (2) the degree of improvement of wound healing in the airway by applying modified microskin transplantation techniques from burn surgery to cover a relatively large wound with a few small pieces of mucosa anchored in place with the previously mentioned technique. Design: Three (one control and two experimental) rectangular (10×8 mm) wounds in tracheal mucosa were produced in four experimental animals (dogs) using a carbon dioxide laser. The control wound was left uncovered. In the first experimental wound, a mucosal flap was raised and then fixed in place by a trapdoor flap method. In the second experimental wound, two small (each 2×3 mm) autogenous mucosa grafts were anchored onto the surface with indocyanine green—dyed albumin activated with an 810-nm diode laser. Histomorphologically, the postoperative results from three wounds were compared. Results: The experimental wounds were completely covered by regenerated squamous cells in 1 week and by ciliated epithelium in 2 weeks after the operation despite the discrepancy in size of the graft to wound area (1:6.7) covered with the stamp mucosa. No thermal damage from the diode laser was noted in the second experimental wounds. In the control wounds, no coverage was observed at 1 week, and only squamous cells were noted 2 weeks postoperatively. All the wounds had normal ciliated epithelium coverage at 4 weeks. Conclusions: Transplanted stamp grafts provided similar or better healing than trapdoor flap transplants. This new technique made endoscopic mucosal grafting possible and offers a potential breakthrough in the management of laryngotracheal stenosis. (Arch Otolaryngol Head Neck Surg. 1995;121:773-777)

This publication has 8 references indexed in Scilit: