Repair of Oronasal Fistulae with Acellular Dermal Matrices

Abstract

This study demonstrates successful closure of palatal fistulas in an animal model and in cleft palate patients using interposition grafts of acellular dermis. This novel method offers promise as a simple and effective technique for tension-free closure of oronasal fistulas.

Intramural acellular porcine dermal matrix (APDM)-assisted gastrotomy closure for natural orifice transluminal endoscopic surgery (NOTES)

“…Remarkably, there is evidence of matrix incorporation into the gastric wall as early as 3 weeks. Plump fibroblast migration into matrix accompanied by endothelial cells confirms that the APDM functions as a scaffold sufficient for fibroblast infiltration and neovascularization, consistent with the findings from other porcine dermal matrices [15,25] and its human counterpart, Alloderm TM (LifeCell) [10,13,26]. Further long-term survival studies are needed to determine whether the APDM also becomes completely remodeled and replaced by the surrounding host tissue.…”

Repair of Oronasal Fistulae by Interposition of Multilayered Amniotic Membrane Allograft

“…32 Kirschner et al 21 described oronasal fistula repair with acellular dermal matrices. In a swine model in the first part of the study and in a clinical trial with nine patients in the second part, the authors achieved convincing results.…”

“…28 A multitude of closure techniques have been suggested, such as mucoperiosteal flaps, 29 pedicled tongue flaps, 30 and free flaps, 20 but many methods can cause donor-site morbidity. 21,31 The use of an external biomaterial might represent one way to preserve healthy tissue without the limitations in local quantity and restrictions caused by cicatrization. Donor-site morbidity can be avoided by the use of alternative biological materials.…”

“…In 2006, Kirschner et al 21 introduced the use of human acellular dermal matrices for oronasal fistula repair. The authors observed the ingrowth of fibrovascular tissue and complete fistula closure in nine patients.…”

Acellular dermal matrix for the treatment of a persistent tracheoesophegeal fistula

“…1 This results in graft incorporation that is indistinguishable from its host tissues within 4 weeks. 3 Furthermore, these grafts have proven to be relatively resistant to wound contracture, 4 all features which make it a logical and appealing option in TEF repair.…”