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. 2017 Jan-Apr;50(1):79-81.
doi: 10.4103/ijps.IJPS_124_16.

Harvesting split thickness costal cartilage graft

Sunil Gaba  1 , Richa Gupta  2 , Bharat Mishra  1 , Daisy Sahni  2
Affiliations

Harvesting split thickness costal cartilage graft

Sunil Gaba et al. Indian J Plast Surg. 2017 Jan-Apr.

Abstract

Aim: There are few complications associated with harvesting of full thickness coastal cartilage grafts i.e., pneumothorax (0.9%), contour deformities and prolonged post-operative pain. To address these issues, authors devised special scalpel to harvest split-thickness costal cartilage grafts.

Materials and methods: Standard inframammary incision was used for harvesting rib. Incision was made directly over the desired rib. Specially designed scalpel was used to cut through the rib cartilage to the half of the thickness. The study was conducted in two parts - cadaveric and clinical.

Results: There was significantly less pain and no pneumothorax in the patients in whom the split thickness graft was harvested. Wounds healed without any complication.

Discussion: Thus, newly devised angulated scalpel used in the current study, showed the potential to supply the reconstructive surgeon with split thickness rib graft without risk of complications such as pneumothorax or warping contour deformities and post-operative pain.

Keywords: Graft; pneumothorax; rib; scalpel; split.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Non-motorized rib cutter device - The handle (x) was made by cutting and bending an aluminium sheet. It was designed so that a 10 or 22 number disposable blade could be fixed to it. It has been angulated in two places, first one (y), about 110°, where the blade is attached and second one, about 70°, where it is to be held while taking the graft
Figure 2
Figure 2
(a) Cadaver thorax. (b) Exposure of the rib. (c) Split rib harvested using the specially designed scalpel. (d) Post split rib harvesting showing no damage to rest of rib and underlying pleura
Figure 3
Figure 3
(a) Exposure of the rib to be harvested through infra mammary incision. (b-c) Split rib harvested using the specially designed scalpel. (d) Harvested split rib and donor rib showing no breach in continuity and safety of pleura
Figure 4
Figure 4
(a) Harvested split thickness cartilage (b) diced cartilage wrapped in rectus fascia for dorsal augmentation
See this image and copyright information in PMC

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