Effects of Basic Fibroblast Growth Factor-2 and Hyaluronic Acid on Tracheal Wound Healing

Objectives: To evaluate basic fibroblast growth factor-2 (BFGF) and hyaluronic acid (HA) effects on a surgically produced tracheal defect. Study Design: Animal model. Methods: Anterior punch lesions were created on 33 male rabbits divided into three equal groups. Group I (Control) received a normal saline (NS)-soaked collagen sponge directly on the defect, group 2 (HA alone) a NS-soaked HA sponge, and group 3 (BFGF+HA) a 10 ng/mL BFGF-soaked HA sponge. Sponge fixation and surgical closure were followed by a 90-day healing period, then animal sacrifice. Harvested tracheas were fixed, imbedded, sectioned, and stained with hematoxylin and eosin or safranin-O. Histopathological measures included: chondrocyte death, chondrocyte proliferation (both reported as number of rabbits displaying death or proliferation per group/total rabbits per group [%]), connective tissue (CT) organization (graded on a scale), epithelial closure (1-3 scale), and inflammation (1-4 scale). The final three measures are reported as an average grade per group, where values closer to 1 signify improved healing, whereas higher values signify poorer healing. Results: Chondrocyte death: Control, 8/11 (72.7%); HA alone, 5/11 (45.5%); BFGF+HA 5/11 (45.5%). Chondrocyte proliferation: 3/11 (27.3%), 7/11 (63.6%), and 9/11 (81.8%), respectively. CT organization: 2.00, 1.82, 1.64. Epithelial closure: 1.18, 1.09, and 1.00. Inflammation: 2.82, 1.82, and 1.73. Statistical comparisons: significantly improved chondrocyte proliferation for BFGF+HA (P = .015) and reduced inflammation for HA alone (P = .011) and BFGF+HA (P = .004) compared to controls. Conclusions: BFGF+HA applied to an anterior tracheal defect significantly improves chondrocyte proliferation; HA alone and BFGF+HA significantly reduce inflammation. BFGF+HA and HA alone may improve tracheal wound healing.