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October 1995

Composite Graft Survival: An Auricular Amputation Model

Author Affiliations

From the Division of Otolaryngology Head and Neck Surgery (Drs Henrich, Logan, and Shockley) and College of Medicine (Mr Lewis), University of North Carolina, Chapel Hill.

Arch Otolaryngol Head Neck Surg. 1995;121(10):1137-1142. doi:10.1001/archotol.1995.01890100049008

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)

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