THE FATE OF THE SKIN-GRAFT IN LARYNGOPLASTY

In laryngoplasty procedures, laryngotracheal soft tissue defects are o ften repaired using skin grafts. While stenting is necessary to approx imate and immobilize the graft, prolonged stenting causes increased ba cterial counts, granulation tissue formation, tissue ischemia, and gra ft failure. Optimal time for stent removal has not been experimentally defined. Using the ferret animal model, 24 laryngoplasty procedures w ere performed, The subjects were stented by group for 0, 3, 7, 14, or 28 days. Analysis consisted of quantitative bacteriology dye perfusion , and quantitative histologic assessment of graft viability. Tissue cu lture results revealed that by 3 days after the procedure all groups h ad 10(5) CFU of bacteria per gram of tissue. Graft viability in succes sful procedures was maximal in the 7-day group and statistically signi ficant hom the 3-day to the 28-day groups. In conclusion, while stenti ng is necessary for graft adherence, prolonged exposure to local tissu e sepsis leads to progressive graft destruction.