Prevention of infectious complications in tracheal defects using a biodegradable polylactide patch: an experimental study.

OBJECTIVE: Tracheal surgery is associated with substantial morbidity, and anastomotic failure can lead to life-threatening infectious complications such as mediastinitis. This study aimed to evaluate whether a biodegradable polylactide patch can close an experimental tracheal defect in mice and prevent such complications. METHODS: In 30 male BALB/c mice, a window defect was created in the anterior tracheal wall. In Group 1 (control, n = 15) the defect was closed with two interrupted sutures only. In Group 2 (experimental, n = 15) the defect was repaired using an electrospun polylactide (PLA) patch secured with two interrupted sutures. Postoperative monitoring included daily semiquantitative clinical scoring (6 parameters, 0-3 scale) in addition to survival and histological assessment on days 7, 14, and 21. RESULTS: All mice in the experimental group survived with no signs of infection and clinical scores ≤ 1. In the control group, 5 of 15 mice developed cervical phlegmon (two died spontaneously, three were euthanized with purulent exudate); the other 10 mice without phlegmon survived. Histologically, the control group exhibited persistent inflammation, tissue disorganisation, and incomplete epithelial regeneration (flattened epithelium with occasional ciliated patches). The PLA patch group showed progressive polymer degradation, minimal inflammation, and complete restoration of a ciliated respiratory epithelium by day 21. CONCLUSION: The PLA patch prevented infectious complications and mortality, promoted full ciliated epithelialization, and demonstrated high biocompatibility, supporting its use in tracheal reconstructive surgery.