Objective:
To study the effects of corticosteroids and fibroblast growth factor on composite graft survival using a rabbit model of auricular amputation and reimplantation.
Design:
Randomized, "blinded," placebo-controlled, prospective animal study.
Setting:
Animal laboratory in tertiary care center.
Intervention:
Amputation of the distal 2 cm of the rabbit ear as a composite graft and reimplantation with simple 6-0 prolene sutures. All animals underwent the same surgical procedure and were randomized into the following four groups: (1) surgical reimplantation alone; (2) 30 mg/kg intramuscular methylprednisolone sodium succinate for 5 days, starting immediately postoperatively; (3) topical basic fibroblast growth factor for 5 days postoperatively; and (4) delayed reimplantation with corticosteroids. In group 4, the ears of the animal were amputated, placed in iced saline containers for 90 minutes, and given 30 mg/kg intramuscular methylprednisolone for 5 days, with the first dose starting immediately prior to reimplantation.
Main Outcome Measures:
Percentage graft survival and histologic characteristics of viable and nonviable composite graft tissue.
Results:
The groups that received corticosteroids and delayed reimplantation with corticosteroids had a statistically significant increase in percentage of graft survival compared with the control group (P<.003 and P<.006, respectively). The growth factor group showed no significant difference from the control group.
Conclusion:
Neovascularization occurred in the viable grafts, thus suggesting its role in graft survival. This study establishes the efficacy of corticosteroids in enhancing composite graft survival.(Arch Otolaryngol Head Neck Surg. 1995;121:1137-1142)