Facial Plast Surg 2015; 31(04): 401-410
DOI: 10.1055/s-0035-1562878
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Liquid Nitrogen on Bone Graft Survival

Hakan Sirinoglu
1   Department of Plastic, Reconstructive and Aesthetic Surgery, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
,
Özlem Tuğçe Çilingir
2   Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
,
Ozhan Çelebiler
3   Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey
,
Feriha Ercan
2   Department of Histology and Embryology, Marmara University School of Medicine, Istanbul, Turkey
,
Ayhan Numanoglu
3   Department of Plastic, Reconstructive and Aesthetic Surgery, Marmara University School of Medicine, Istanbul, Turkey
› Author Affiliations
Further Information

Publication History

Publication Date:
15 September 2015 (online)

Abstract

Liquid nitrogen is used in medicine for cancer treatment and tissue preservation; however, bone viability after its application is controversial. This study aims to evaluate both the tissue viability and the clinical and histopathologic findings following liquid nitrogen application with different thawing techniques in rats. Mandibular bone grafts were taken from 45 Wistar rats and freezed in liquid nitrogen for 20 minutes. In the rapid-thawing technique (Rapid Thawing-1, Rapid Thawing-2), the grafts were held for 20 minutes in room temperature; in the slow-thawing technique (Slow Thawing-1, Slow Thawing-2), 20 minutes in −20°C, 20 minutes in +4°C, and 20 minutes in room temperature, respectively. In Rapid Thawing-2 and Slow Thawing-2 groups, autografts were implanted to their origin for 3 weeks and bone staining with India ink was performed and samples taken for histologic examination. The amount of cells and blood vessels and the density of bone canaliculi were significantly reduced in Rapid Thawing-1 and Slow Thawing-1 groups comparing to the Control group. However, the reduction rate was more significant in the Slow Thawing-1 group. Histomorphometric evaluation of the healing autografts after 3 weeks revealed that the decreased amounts of canaliculi were not changed in Slow Thawing-2 group. The study results demonstrated that bone tissue survives after liquid nitrogen treatment regardless of the performed thawing technique; however, slow thawing causes more tissue damage and metabolism impairment.

 
  • References

  • 1 Taylor BC, French BG, Fowler TT, Russell J, Poka A. Induced membrane technique for reconstruction to manage bone loss. J Am Acad Orthop Surg 2012; 20 (3) 142-150
  • 2 Goodrich JT, Sandler AL, Tepper O. A review of reconstructive materials for use in craniofacial surgery bone fixation materials, bone substitutes, and distractors. Childs Nerv Syst 2012; 28 (9) 1577-1588
  • 3 Hagen A, Gorenoi V, Schönermark MP. Bone graft substitutes for the treatment of traumatic fractures of the extremities. GMS Health Technol Assess 2012; 8: Doc04
  • 4 Costantino PD, Hiltzik D, Govindaraj S, Moche J. Bone healing and bone substitutes. Facial Plast Surg 2002; 18 (1) 13-26
  • 5 Yamamoto N, Tsuchiya H, Tomita K. Effects of liquid nitrogen treatment on the proliferation of osteosarcoma and the biomechanical properties of normal bone. J Orthop Sci 2003; 8 (3) 374-380
  • 6 Abdel Rahman M, Bassiony A, Shalaby H. Reimplantation of the resected tumour-bearing segment after recycling using liquid nitrogen for osteosarcoma. Int Orthop 2009; 33 (5) 1365-1370
  • 7 Meller I, Weinbroum A, Bickels J , et al. Fifteen years of bone tumor cryosurgery: a single-center experience of 440 procedures and long-term follow-up. Eur J Surg Oncol 2008; 34 (8) 921-927
  • 8 Tanzawa Y, Tsuchiya H, Yamamoto N, Sakayama K, Minato H, Tomita K. Histological examination of frozen autograft treated by liquid nitrogen removed 6 years after implantation. J Orthop Sci 2008; 13 (3) 259-264
  • 9 Ersoy B, Sirinoğlu H, Bayramiçli M. A new role for hygienic pad in the laboratory settings. Microsurgery 2010; 30 (5) 422
  • 10 Ozkan O, Akyürek M, Safak T, Kayikçioğlu A, Güler G, Erk Y. A new flap model in rats: iliac osteomusculocutaneous flap. Ann Plast Surg 2001; 47 (2) 161-167
  • 11 Nasir S, Aydin A, Kayikçioğlu A, Sökmensüer C, Cobaner A. New experimental composite flap model in rats: gluteus maximus-tensor fascia lata osteomuscle flap. Microsurgery 2003; 23 (6) 582-588
  • 12 van der Geest IC, de Valk MH, de Rooy JW, Pruszczynski M, Veth RP, Schreuder HW. Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1. J Surg Oncol 2008; 98 (6) 421-426
  • 13 Tanzawa Y, Tsuchiya H, Shirai T, Hayashi K, Yo Z, Tomita K. Histological examination of frozen autograft treated by liquid nitrogen removed after implantation. J Orthop Sci 2009; 14 (6) 761-768
  • 14 Gage AA, Baust JG. Cryosurgery—a review of recent advances and current issues. Cryo Lett 2002; 23 (2) 69-78
  • 15 Garusi C, Calabrese L, Giugliano G , et al. Mandible reconstruction and autogenous frozen bone graft: experimental study on rats. Microsurgery 2001; 21 (4) 131-134
  • 16 Dabak N, Tomak Y, Piskin A, Gulman B, Ozcan H. Early results of a modified technique of cryosurgery. Int Orthop 2003; 27 (4) 249-253
  • 17 Costa FW, Brito GA, Pessoa RM, Studart-Soares EC. Effect of different cryosurgical protocols using liquid nitrogen on bone tissue: a histomorphological analyze. J Clin Exp Dent. 2011; 3 (2) 91-96
  • 18 Tsuchiya H, Nishida H, Srisawat P , et al. Pedicle frozen autograft reconstruction in malignant bone tumors. J Orthop Sci 2010; 15 (3) 340-349
  • 19 Costa FW, Brito GA, Pessoa RM, Studart-Soares EC. Histomorphometric assessment of bone necrosis produced by two cryosurgery protocols using liquid nitrogen: an experimental study on rat femurs. J Appl Oral Sci 2011; 19 (6) 604-609
  • 20 Nishida H, Yamamoto N, Tanzawa Y, Tsuchiya H. Cryoimmunology for malignant bone and soft-tissue tumors. Int J Clin Oncol 2011; 16 (2) 109-117
  • 21 Pegg DE. The preservation of tissues for transplantation. Cell Tissue Bank 2006; 7 (4) 349-358
  • 22 Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37 (3) 171-186
  • 23 Robilotto AT, Baust JM, Van Buskirk RG, Gage AA, Baust JG. Temperature-dependent activation of differential apoptotic pathways during cryoablation in a human prostate cancer model. Prostate Cancer Prostatic Dis 2013; 16 (1) 41-49
  • 24 Clarke DM, Hollister WR, Baust JG, ; Van Buskirk RG. Cryosurgical modeling: sequence of freezing and cytotoxic agent application affects cell death. Mol Urol 1999; 3 (1) 25-31
  • 25 Jardini MA, De Marco AC, Lima LA. Early healing pattern of autogenous bone grafts with and without e-PTFE membranes: a histomorphometric study in rats. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100 (6) 666-673