Purpose: Viability and feasibility of Surgicel-wrapped diced cartilage grafts (DCS) versus fascia-wrapped grafts (DCF) remains debated. Clinical failures and histological findings in human DCS prompted animal investigation to compare behaviors of unwrapped diced cartilage (DC) with DCS and DCF.

Methods: Human cartilage was diced and implanted in athymic rats as DC, DCS or DCF. At eight weeks the specimens were processed, stained, and evaluated for viability and architecture.

Clinical Application: DCF grafts were utilized to reconstruct failed DCS grafts (radix, dorsum, parapyriform, malar, etc.)in nasofacial reconstruction patients. Biopsy specimens obtained from clinical grafts during revision operations were analyzed.

Results: Experimental arm: DCS had the lowest viability and staining while DCF had the highest, with H & E, Trichrome, Safranin-O, and Von Giesson stains. Absolute numbers of nucleated and basophilic lacunae were significantly higher for DCF grafts. Clinical histology validated these findings.

Conclusions: Surgicel incites, while fascia minimizes,inflammatory response and cartilage absorption in diced cartilage grafts. This experimental study demonstrates that deep temporal fascia is the preferred envelope to facilitate graft containment and maintain chondrocyte viability. Laboratory findings are consistent with clinical use of DCF grafts. Long term permanence with DCF grafts proves encouraging with results at two years.