On the Use of Unsealed Polypropylene Mesh as Tracheal Replacement

Abstract

The necessity of a cervical tracheal replacement arises with thyroid carcinoma, which occasionally infiltrates the trachea extensively, the rare primary tracheal tumors and, sporadically, benign stenoses. In the present study, we used an uncoated porous polypropylene prosthesis as cervical tracheal replacement in sheep. Specifically, we implanted a tracheal prosthesis of polypropylene mesh as a cervical tracheal replacement in five sheep, protecting the airways with self-expanding stents. Healing-in of the prostheses was checked bronchoscopically. The animals were killed after increasing survival times (7, 28, 64, 68, and >90 days), and incorporation of the prosthesis was examined macroscopically, microangiographically and histologically. Although medium-term survival was possible with a sufficiently wide airway, all animals were ultimately euthanized because of complications (airway stenosis, prolapse of prosthesis). Nevertheless, the results show that replacement of the cervical trachea with a polypropylene mesh can be successful under different experimental conditions.

Composite cervical skin and cartilage flap provides a novel large airway substitute after long-segment tracheal resection

“…7,8,19 Some investigators have attempted to use various vascular growth factor to improve blood supply to the grafts. 20 Pretreating tracheal allografts has been used with limited success. 9 Cryopreservation reduces acute rejection 21 ; however, the allograft ultimately succumbs to chronic rejection with vascular thrombosis and degeneration.…”

Tracheal Replacements: Part 2

“…Polymer coatings or tissue wraps (omentum, fascia, and pericardium) have been used to decrease air leaks. Materials of meshes used experimentally include steel wire 3,6,11,[33][34][35][36] wrapped with tissue (such as omentum, fascia, pericardium) for air tightness; stainless steel wire lined with dermis or synthetic materials 2 ; Tantalum 3,26,29,33,37-39 with or without pleura or fascia; coated titanium fiber metal 40 ; Marlex 11,[41][42][43][44][45] ; Marlex with collagen reinforced by polypropylene spiral 46 -49 ; polytetrafluoroethylene (PTFE) 33,50 -54 ; porous high density polyethylene (PHDPE) 55 ; polyurethane 56 ; Ivalon and wire 12,57,58 ; Dacron and polyurethane 59 ; Prolene mesh reinforced with polypropylene rings 60 ; uncoated porous polypropylene, 61 and Teflon. 33 Materials with experimental success or promise are shown in Table 3.…”

Porous Three-Dimensional Silk Fibroin Scaffolds for Tracheal Epithelial Regeneration in Vitro and in Vivo

“…Nonbiologically derived scaffolds without bioactivity give excellent mechanical strength but may elicit inflammatory reactions, immunogenic response, and discourage cell growth. Tissue-engineered airway scaffolds using purely natural materials (e.g., type I collagen, hyaluronic acid, and gelatin) have not been frequently utilized because of their limited mechanical properties. − …”