The scalpel is currently the instrument used by most surgeons for carving costal cartilage grafts. However, this method is time consuming, requires a high degree of skill, and is far from ideal for reproducibly attaining uniform slices, even in expert hands. The authors present a costal cartilage cutter, which uses a clamping mechanism that rapidly secures harvested rib, while a guide facilitates a double-bladed cutter to easily produce cartilage slices with highly uniform thickness. The authors present their results using porcine rib (4cm length, 1cm width). Twenty-five samples of each of three different thicknesses (1mm, 2mm, 3mm) were sectioned using minimally compression, and 25 samples of 2mm thickness were cut using maximal compression of the stabilising device. All porcine specimens cut using minimal compression appeared uniform, with a percentage difference in thickness for each sample ranging between 11% mean for 3mm slices and 18% mean for 1mm slices. Porcine cut with maximum resulted in a percentage difference in thickness of 35% mean. The device was additionally used in nine rhinoplasty cases that required costal grafting. Caudal septal extension grafts were constructed from 2mm slices. Lateral crural strut grafts, alar rim grafts and spreader grafts were often fashioned from 1mm. The canoe-shaped peripheral slices were utilised as dorsal onlay grafts. Cartilage slices obtained from initially curved donor rib retained the curved shape after cutting.
Simplification measure for costal cartilage grafting
Reviewed by Gregor M Bran
Precise and rapid costal cartilage graft sectioning using a novel device.
