Free Periosteal Grafts in Tracheal Reconstruction

In obstructive lesions of the trachea it is currently agreed that the best method of treatment is resection of the lesion followed by direct tracheal end-to-end anastomosis. On some occasions, however, this is not feasible, and recourse to other methods of reconstruction is then necessary. Various forms of grafting, with auto- and allografts, have been used both experimentally and clinically. One source of graft material, is the periosteal membrane, which is used in the form of free or pedicled grafts. It has been shown that this method leads to epithelialization of the defect, and cartilage and bone formation allows a stable tracheal wall to be obtained (Kufaas 1981; Kufaas and Pasila 1974; Olsen and Nordin 1976; Ritsila and Alhopuro 1973).