Viability study of cartilage grafts wrapped in biological materials

Objective: The aim of this study is to compare cartilage viability in diced cartilage grafts wrapped with human cadaveric dermis (FlexHD®), bovine pericardium (Tutopatch®), and allogeneic human fascia and facilitate their clinical use. Materials and Methods: For this study, 5 SCID (Severe Combined Immunodeficiency)/Gamma Mice were used. The cartilage grafts were obtained from the remaining cartilage following secondary rhinoplasty performed on a 35-year-old male patient. Diced cartilage grafts were wrapped separately with Acellular Dermal Matrix (ADM), Tutopatch, and fascia to form three groups. A total of five mice were utilized in all three experimental groups, with a total of 15 experimental materials being examined. One composite graft from each group was implanted into the backs of the mice. The pre and post-implantation weights of the composite grafts were measured using a precision balance, and their volumes were measured using computed tomography. Histopathological viability evaluation was performed using hematoxylin-eosin, Masson's trichrome, and Toluidine blue. The cartilage viability was measured using flow cytometry. Results: A significant increase in weight was found in the fascia group after implantation (p<0.05). In the ADM and Tutopatch groups, no statistically significant weight change was observed (p>0.05). A significant increase in volume was found in the ADM group after implantation. Flow cytometry showed the highest cartilage viability percentage in the fascia group and the lowest in the ADM group. No significant difference was found in viability percentages between the groups. Histopathological examinations supported the flow cytometry findings. Conclusion: Our study revealed that cartilage grafts wrapped in fascia demonstrated better viability and stability compared to other materials. However, these results did not show statistically significant superiority when compared to ADM and Tutopatch. This suggests that while fascia may remain the gold standard, alternative biomaterials also hold potential. Further experimental and clinical studies with larger sample sizes are needed to support these findings. Keywords: Acellular Dermal Matrix, Bovine Pericardium, Composite Cartilage Graft, Diced Cartilage Fascia (DC-F), Dorsal Augmentation