Abstract | BACKGROUND/PURPOSE: METHODS: Polytetrafluoro- ethylene ( PTFE) and fluorinated polyester (FP) were randomised for laparoscopic patch insertion into 12 lambs. All lambs (age <4 weeks) underwent 3-port laparoscopy, surgical creation of diaphragmatic hernia, and sutured patch placement. Two PTFE and 2 FP lambs were killed at 1-, 3-, and 6-month intervals postoperatively. Postmortem examination histopathology, electron microscopy, and specific bacterial broth immersion (Escherichia coil, Staphylococcus aurens, and epidermidis) were performed. RESULTS: All 12 lambs completed the study with intact patches that were fully peritonised. One abdominal adhesion was noted in a FP lamb at 6 months. FP was comparatively easier to insert, manipulate, and suture endoscopically. Histopathology findings showed that PTFE patches created a strong peripheral foreign body reaction with dystrophic calcification, whereas FP was well incorporated with intrapatch fibroblastic activity and neovascularsation. No significant difference in resistance to bacterial adhesion of relevant organisms was noted between the materials. Graft shrinkage for FP was 7% in one direction only, evident by 3 months. CONCLUSIONS: Fluorinated polyester has advantages in this laparoscopic lamb model. It shows rapid and sustained incorporation with intrapatch neovascularisation when compared with polytetrafluoro- ethylene's significant foreign body reaction. It was preferred for its endoscopic handling and suturing properties. The laparoscopic techniques used may contribute to the general lack of adhesions, and insufficient data are available to comment on the comparative effect of the materials on adhesion formation. No difference was demonstrated in resistance to bacterial adherence in the harvested materials.
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Authors | C P Kimber, M P Dunkley, G Haddock, L Robertson, F A Carey, A Cuschieri |
Journal | Journal of pediatric surgery
(J Pediatr Surg)
Vol. 35
Issue 1
Pg. 120-3
(Jan 2000)
ISSN: 0022-3468 [Print] United States |
PMID | 10646788
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Biocompatible Materials
- Polyesters
- Polytetrafluoroethylene
- Fluorides
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Topics |
- Animals
- Bacterial Adhesion
- Biocompatible Materials
- Fluorides
- Foreign-Body Reaction
(pathology)
- Hernia, Diaphragmatic
(surgery)
- Hernias, Diaphragmatic, Congenital
- Laparoscopy
- Polyesters
- Polytetrafluoroethylene
- Sheep
- Surgical Mesh
(adverse effects, microbiology)
- Tissue Adhesions
- Wound Healing
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