A technique for creating a skin-lined hemithorax

Abstract

Abstract Prosthetic lungs could permanently occupy the pleural space which must first be lined with silicone ‘skin’, i.e., Dacron-backed silicone membrane (Peirce, 1966). Initial experiments in dogs showed that the pleural membrane would not readily accept silicone ‘skin’; rather, the solution lay in the use of autogenous skin-grafts. A readily reproducible technique has been eveloped for transforming the left hemithorax of SPF rats into stable skin-lined cavities which can be opened to atmospheric pressure without embarrassing breathing in the contralateral lung. Authogenous skin was formed into 35 × 20-mm. sacs and grafted into the left pleural spaces of 150 male SPF rats of mean weight 240±30 g. One hundred and thirty-two (88 per cent) survived 4 weeks or more. In these the skin-lined cavity grew to occupy the hemithorax, displacing the left lung. In 75 rats the cavity was opened to the exterior and sutured to the skin, thereby creating a permanent 5–8-mm. opening directly through the chest wall. Fifty-nine of the 75 rats so exposed survied. The mean pressure in the cavity was +2.9±0.6 cm. H2O before it was opened to the exterior; after the creation of the stoma the mean pressure in the cavity became −2.5±0.6 cm. H2O (P < 0.001), and the new pressure was in phase with and was similar in magnitude to the oesophageal pressure. The skin-lined hemithorax is presented as the model of a cavity which could be employed to house prosthetic organs designed for permanent implantation insie the chest cavity.