Document Detail

Effect of surgical manipulation of polytetrafluoroethylene grafts on microstructural properties and healing characteristics.
MedLine Citation:
PMID:  1443379     Owner:  NLM     Status:  MEDLINE    
The effects on graft healing of alterations in the microstructure of polytetrafluoroethylene (PTFE) grafts induced by surgical instruments have not been fully elucidated. This study evaluates changes in the structural and physical properties of PTFE grafts resulting from the intentional application of commonly used surgical instruments and the influence of these changes on cellular ingrowth. The extent of cellular ingrowth into intact (10, 30, and 60 microns unreinforced and 30 microns reinforced [R]) and structurally compromised PTFE grafts (30 reinforced and 60 microns nonreinforced) implanted subcutaneously in Sprague-Dawley (n = 14) rats was evaluated at 7 and 21 days. The thrombogenicity of 10-, 30-, 60-, and 80-microns intact graft segments was determined gravimetrically after suspension in the internal jugular vein of dogs for 90 minutes. Cellular ingrowth consisting of fibroblasts, macrophages, and microvessels was directly related to porosity and was most extensive in 60-microns uncompromised graft segments, being 7-, 17-, and 20-fold greater than was observed in 60- and 30R-microns compromised grafts and undamaged 10-microns grafts, respectively. There was a direct relationship between porosity and thrombogenicity of intact graft segments suspended in the jugular vein. The amount of thrombus adherent to 80-microns graft segments was eightfold greater compared with 10-microns grafts. Manipulation of PTFE with surgical instruments significantly impairs healing and may be a possible etiologic factor in the poor long-term performance of these grafts.
H Holubec; G C Hunter; C W Putnam; D A Bull; W D Rappaport; M Chvapil
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  164     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-14     Completed Date:  1992-12-14     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  512-6     Citation Subset:  AIM; IM    
Department of Surgery, University of Arizona Health Sciences Center, Tucson 85724.
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MeSH Terms
Blood Vessel Prosthesis*
Blood Vessels / pathology*
Fibroblasts / pathology
Giant Cells / pathology
Jugular Veins / surgery
Macrophages / pathology
Microscopy, Electron, Scanning
Polytetrafluoroethylene / chemistry*
Rats, Sprague-Dawley
Surface Properties
Surgical Instruments*
Thrombosis / etiology*,  pathology
Wound Healing
Reg. No./Substance:

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