USE OF THE PLATYSMA MYOCUTANEOUS FLAP FOR CERVICAL TRACHEA RECONSTRUCTION - AN EXPERIMENTAL-STUDY IN DOGS

Cervical trachea reconstruction with a nonstented platysma myocutaneou s door flap (NPMCF) was studied in 23 dogs. Window defects involving 5 , 10, or 15 rings and the whole anterior tracheal wall were produced i n 3 different groups of animals. A segmentary defect involving the res ection of 3 tracheal rings but preserving the posterior membranous wal l was created in another group. The results were evaluated by clinical follow-up of up to 100 days, by tracheoscopy 1 week after surgery, an d by macroscopic and microscopic examination after the animals' natura l death or sacrifice. The NPMCF proved to be adequate for the reconstr uction of window defects limited to 5 and 10 rings, with success rates of 100% and 75%, respectively. The use of the NPMCF for tracheal reco nstruction had the following main advantages: 1. relatively simple, ea sy, and expeditious surgery; 2. use of a single operative field; 3. av ailability of large amounts of donor tissue; 4. adequate thickness; 5. reliable irrigation; 6. resistance to environmental exposure as evide nced by absence of infection; and 7. 100% take rate with no granulomas or scar stenosis at the suture lines. However, luminal occlusion due to flap collapse was a 100% fatal complication when the NPMCP was used either for reconstruction of larger window tracheal defects (15 rings -group 3) or segmentary defects (group 4); this was the main limitatio n of the method, followed by hair growth with accumulation of secretio ns, which can be easily dealt with. It can be anticipated that this me thod has a potential for application in well-selected patients.