Wound management of the airway mucosa: comparison with skin in a rabbit model

In comparison to the extensive study of skin wound hearing, there have been few reports investigating mucosal wound healing. Our primary objective was to compare the natural progression of wound healing in airway mucosa to sk in in a rabbit model. Split-thickness skin wounds and subglottic mucosal wo unds created by drill injury were compared on days 0, 1, 3, 5, 7, 14 and 21 after injury. Histologic examination was performed by a veterinary patholo gist blinded to sample identity. Subglottic wounds showed a 'fibrinous clot ' overlying the epithelium, analogous to the fibrin crust in skin wounds. R e-epithelialization started on day 5 in the subglottic epithelium and was c omplete by day 14; fibroplasia and fibrosis in the lamina propria were pres ent on days 7-21. This wound healing profile paralleled the skin epidermis and dermis, respectively The epithelial changes, however, were temporally e xtended in the airway Our secondary objective was to determine the effects of treating airway mucosa with a bioresorbable membrane, modified sodium hy aluronate and carboxymethylcellulose (modified HA/CMC), placed over the sub glottic wounds of four rabbits after drill injury. Subglottic wounds treate d with modified HA/CMC showed a more mature epithelium and less fibrosis on day 21. In this pilot study, the application of a bioresorbable membrane i mproved mucosal wound healing at both the epithelial and lamina propria lev els. Clearly, a larger study must be performed to confirm this interesting observation. (C) 1998 Published by Elsevier Science Ireland Ltd. All rights reserved.