Rib Cartilage Works Well for Plastic Surgery
(Ivanhoe Newswire) -- Rib cartilage from human donors is well tolerated as a grafting material in nasal plastic surgery and yields positive functional, structural and cosmetic results, even in complex cases.
"The search for the ideal nasal implant remains an ongoing effort," the authors wrote. "We desire a substance that is readily available in large quantities, resists infection and absorption, is completely integrated into host tissues, causes little patient morbidity and can be molded, shaped or carved with ease."
The patient's own cartilage is the preferred choice, but sometimes it is too thin, there is an insufficient quantity or problems may occur at the site from which it is removed. An alternative is donor tissue from human ribs that has been treated with radiation to decrease the chances of an immune response once placed in a donor.
Russell W. H. Kridel, M.D., of the University of Texas Medical School at Houston and Facial Plastic Surgery Associates, Houston, and colleagues reviewed the medical charts of 357 patients who underwent nasal plastic surgery (rhinoplasty) using costal cartilage as the principal graft material between 1984 and 2008.
The 1,025 homologous costal cartilage grafts (using cartilage from a donor) and 373 other grafts used were evaluated for warping, infection, resorption (being absorbed back into surrounding tissues) with or without infection, mobility and extrusion (forcing out).
"Not only did very few complications occur following the use of 1,025 irradiated homologous costal cartilage grafts in 357 patients after 386 rhinoplasties over 24 years, but the rate of complications was no greater than rhinoplasty complication rates when autologous (the patient's own) cartilage grafts are used," according to the authors.
During follow-up, 94.2 percent of patients reported being satisfied with the results in their appearance, ability to breathe and general quality of life. The irradiated homologous costal cartilage was not associated with any allergic reactions or systemic diseases and also proved to be reliable in patients with autoimmune diseases and in those with complex cases involving repairs of perforated septal tissue.
The authors concluded, "The results indicate safety and reliability and justify the convenient use of irradiated homologous costal cartilage grafts for primary and revision rhinoplasty without creating donor site morbidity," or damage to the area from which an individual's own cartilage is harvested.
SOURCE: Archives of Facial Plastic Surgery, November/December, 2009
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