Dura versus Gore-Tex as an abdominal wall prosthesis in an open and closed infected model | JoVE Visualize

Dura versus Gore-Tex as an abdominal wall prosthesis in an open and closed infected model

¹Department of Pediatric Surgery, University of Pittsburgh School of Medicine, PA 15213-2583.

Journal of Pediatric Surgery|June 1, 1989

View abstract on PubMed

Summary

In infected wounds, Gore-Tex (PTFE) demonstrated superior performance over dura for abdominal wall defect closure. PTFE showed better infection resistance, reduced patch separation, and fewer adhesions in contaminated settings.

Area of Science:

Biomaterials Science
Surgical Innovation
Wound Healing Research

Background:

Large abdominal wall defects often require prosthetic materials for closure, especially in contaminated or infected wounds.
Choosing the appropriate prosthetic material is critical for successful wound healing and minimizing complications.
Gore-Tex (PTFE) and dura are potential materials for abdominal wall reconstruction, but their comparative efficacy in infected scenarios is not well-established.

Purpose of the Study:

To compare the effectiveness of Gore-Tex (PTFE) and dura in closing large abdominal wall defects.
To evaluate resistance to infection, patch separation, and intraperitoneal adhesion formation for both materials.
To determine the optimal prosthetic material for abdominal wall reconstruction in compromised wound environments.

Main Methods:

Ninety guinea pigs underwent full-thickness abdominal defects (2 cm2) patched with either PTFE or dura.
Wounds were managed under three conditions: open, aseptically closed, or contaminated with Staphylococcus aureus and then closed.
Outcomes assessed included patch separation, retention, adhesion formation, and wound healing over 45 days.

Main Results:

Patch separation, retention, and adhesions were comparable between PTFE and dura in open and aseptically closed wounds.
In infected closed wounds, PTFE demonstrated significantly longer incision integrity, delayed patch separation, and improved overall patch retention compared to dura.
PTFE also significantly reduced intraperitoneal bowel adhesions in the infected closed wound model.

Conclusions:

Gore-Tex (PTFE) offers superior outcomes to dura for closing large abdominal wall defects in infected conditions.
PTFE's enhanced resistance to infection and reduced adhesion formation make it a more suitable prosthetic material for contaminated abdominal wounds.
These findings support the use of PTFE in complex abdominal wall reconstructions where infection risk is a concern.