Evaluation of Diced Cartilage Grafts Shaped with Three-Dimensionally-Printed Bioresorbable Polycaprolactone Molds.

BACKGROUND: The main problem with the use of diced cartilage grafts is related to the difficulties encountered in shaping the graft and unpredictible graft resorption. The aim of this study was to evaluate the permanence and viability of diced cartilage grafts shaped with the help of biodegradable, three-dimensionally-printed polycaprolactone molds. METHODS: Three groups were studied in each of the eight rabbits: block cartilage (group 1), diced cartilage (group 2), and diced cartilage shaped with polycaprolactone molds (group 3). A total of 24 cartilage grafts were obtained at the end of the 12-week follow-up period, and 10 different histopathologic parameters were analyzed in each cartilage graft. RESULTS: Diced cartilages shaped with a three-dimensionally-printed polycaprolactone mold showed increased regeneration potential of chondrocytes, vascularization, and collagen production. Use of polycaprolactone molds did not cause any additional risk of inflammation, fibrosis, or metaplastic bone formation. CONCLUSIONS: In this study, it has been shown that three-dimensionally-printed polycaprolactone molds can be used safely in shaping diced cartilage grafts. In light of this study, it will be possible to produce hybrid grafts that can be used safely in many operations such as nasal reconstruction, rhinoplasty, auricle reconstruction, and repair of orbital floor fractures with the help of molds produced in more complex ways. CLINICAL RELEVANCE STATEMENT: Three-dimensionally-printed polycaprolactone molds can be used to shape diced cartilages in the areas of both aesthetic and reconstructive surgery.

Scalp Reconstruction With Free Latissimus Dorsi Flap in a Patient With Giant Cutis Verticis Gyrata.

INTRODUCTION: Cutis verticis gyrata is a rare skin disorder characterized by formation of thick skin folds and grooves. Because of the risk of malignant transformation, these lesions must be surgically excised. In this study, the authors aimed to present a successful reconstruction of scalp with free latissimus dorsi musculocutaneous flap after total excision of giant cerebriform intradermal nevus that causes cutis verticis gyrata. PATIENT REPORT: An 18-year-old male patient attended to our clinic with a large tumor that covers almost 80% of his scalp. Lesion is diagnosed as cerebriform intradermal nevus. Excision of the tumor and scalp reconstruction with free latissimus dorsi musculocutaneous flap is planned and the patient is operated. DISCUSSION: Free tissue transfer is one of the best choices for full thickness defects that covers 80% of scalp with its excellent reconstructive and aesthetical results. Reconstruction with free flaps reduces the number of operations necessary to cover the defect unlike serial tissue expansion or staged excision methods. Free flaps are also a good alternative when the patient has not enough hair-bearing tissue to expand. Low donor site morbidity also makes free latissimus dorsi musculocutaneous flaps excellent choice. CONCLUSION: Cerebriform intradermal nevus is one of the most common causes of cutis verticis gyrata and has an importance due to the current risk of malign transformation. Latissimus dorsi musculocutaneous free flap is a reliable and aesthetically acceptable reconstruction option in the patients of giant cutis verticis gyrata due to sufficient pedicle length, reliable vascularized tissue volume, and large surface area.