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. 2025 Feb 28.
doi: 10.1007/s00266-025-04770-7. Online ahead of print.

New Wrapping Biomaterial Alternatives for Fascia in Diced Cartilage Grafts: A Comparative Study on Viability and Stability

Emre Özer  1 , Aret Çerçi Özkan  2 , Mert Ersan  3 , Uğur Anıl Bingöl  2 , Başak Aru  4 , Şükrü Yıldırım  5 , Murat Aydın Sav  6 , Neslihan Taşdelen  7 , Aylin Yaba Uçar  8
Affiliations

New Wrapping Biomaterial Alternatives for Fascia in Diced Cartilage Grafts: A Comparative Study on Viability and Stability

Emre Özer et al. Aesthetic Plast Surg. .

Abstract

Objective: The aim of this in vivo study is to compare cartilage viability within diced cartilage grafts from the perspective of three wrapping biomaterials Group A acellular dermal matrix (FlexHD®), Group T bovine pericardium (Tutopatch®), and Group F allogeneic human fascia for a possible implementation in the clinical use.

Materials and methods: This in vivo study was conducted on 5 SCID (Severe Combined Immunodeficiency)/Gamma Mice with a duration of eight weeks. The cartilage within composite grafts were obtained from the remaining cartilage following secondary rhinoplasty performed on a single donor. Diced cartilage grafts were wrapped separately with acellular dermal matrix (ADM), bovine pericardium, 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 effects of the biomaterials on the viability and stability of the composite grafts were evaluated. Viability was evaluated through LIVE/DEAD cell analysis and histopathological examinations. Stability was assessed by comparing weight and volume changes of the grafts, measured using a precision balance and computed tomography, respectively.

Results: A significant increase in weight was found in the fascia group after implantation (p < 0.05). In the ADM (Group A) and bovine pericardium (Group T), no statistically significant weight change was observed (p > 0.05). A significant increase in volume was found in the ADM (Group A) group after implantation (p < 0.05). Flow cytometry showed the highest cartilage viability percentage in the fascia (Group F) and the lowest in the ADM (Group A). 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 allogenic fascia (Group F) showed better viability and stability compared with ADM (Group A) and bovine pericardium (Group T). 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.

Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Acellular dermal matrix; Bovine pericardium; Composite cartilage graft; Diced cartilage fascia (DC-F); Dorsal augmentation.

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Conflict of interest statement

Declarations. Conflict of interest: None. Ethics Approval: This study was conducted in strict accordance with ethical guidelines for the care and use of experimental animals. The experimental protocol was reviewed and approved by the [Institutional Ethical Review Board] (Approval Number: 2022-51—Date: 13.12.2022). All procedures performed in the study adhered to the principles outlined in the, EU Directive 2010/63/EU for animal experiments, to ensure humane treatment and minimize discomfort to the animals. Consent to Participate: The patient was informed about the study, and he consented to the study by signing a form. Consent to Publication: The patient was informed about the publication, and he consented to the study by signing a form.

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