Todd E. Simon1, Anna L. Naig1, Joel R. Brockmeyer1, Robert D. Rice1, Balakrishna M. Prasad2, Paul W. White1
1Peripheral Vascular Surgery Service, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA; 2Department of Clinical Investigation, Dwight David Eisenhower Army Medical Center, Fort Gordon, GA.
OBJECTIVES: Autogenous vein and PTFE are two common conduits used to bypass arterial injuries. PTFE is prone to infection and subsequent graft failure in contaminated wounds. Biosynthetic materials used as conduit are potentially more resistant to infection than PTFE. The objective of this study is to compare Permacol, a biosynthetic material, to vein as a vascular conduit for arterial repair in the presence of bacterial contamination.
METHODS: Thirty-six New Zealand white rabbits were randomized to one of four groups: Permacol or autogenous vein graft, with or without bacterial contamination (n=9). All groups underwent interposition grafting of the common carotid artery. Grafts were contaminated with Staphylococcus aureus upon completion of surgery. Grafts were then excised at day 42 and segments were collected for histological evaluation and bacterial load measurement.
RESULTS: Three animals in the contaminated vein group died within 72 hours of surgery. There were no deaths in the other groups. At 42 days, Permacol demonstrated greater patency than vein in the contaminated groups (p>0.05) and equivalent patency in the non-contaminated group. No difference was found between the 2 contaminated groups in the bacterial content of graft material at 42 days.
CONCLUSIONS: When used as a conduit in a contaminated field, Permacol was equivalent to autogenous vein graft with respect to patency and bacterial contamination. When contaminated, Permacol was associated with better survival rates as compared to autogenous vein. Permacol may function as an alternative to autogenous vein as a vascular conduit.
AUTHOR DISCLOSURES: J. R. Brockmeyer, Nothing to disclose; A. L. Naig, Nothing to disclose; B. M. Prasad, Nothing to disclose; R. D. Rice, Nothing to disclose; T. E. Simon, Nothing to disclose; P. W. White, Nothing to disclose.
Posted April 2012