Comparative Study of Collagen Density, Fibroblast, and Neovascularization in Tracheal Defect Reconstruction with Primary Repair and External Oblique Muscle Aponeurosis Patch (A Novel Study with New Zealand Rabbit)

Abstract

Background: The lack of ideal materials and the high incidence of complications make tracheal defect reconstruction challenging. The use of aponeurosis as a surgical patch and flap in reconstruction is not uncommon, but no studies had been conducted to analyse its use in tracheal defect reconstruction, though its effectivity in wound healing was significant in reconstruction of other organs. Objective: This study aims to compare collagen density, fibroblast expression, and neovascularization in tracheal defect reconstruction using primary suture and using external oblique muscle aponeurosis patch. Methods: This randomized control trial is a laboratory experimental study using male New Zealand white rabbits. Randomization was carried out with permuted block randomization into a control group (primary suture) and a treatment group (reconstruction with external oblique muscle aponeurosis patch). Mascroscopic and histopathological assessments were carried out 14 days after surgery. Results: We got homogeneous samples in both groups (9 samples each) in terms of age (p = 0.763), weight before procedure (p = 0.347), and weight after procedure (p = 0.536). Macroscopically, no wound dehiscence, pus, or inflammation at the surgical site in either the control or treatment groups. Histopathological analysis showed that there were no differences in collagen density (p = 1.00), fibroblast expression (p = 0.414), and neovascularization (p = 0.558) between the two groups. Conclusion: It can be concluded that there are no differences in collagen density, fibroblast expression, and neovascularization in New Zealand rabbits with tracheal defect using primary suture and using external oblique muscle aponeurosis patch