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Title: Use of stretch expanded polytetrafluoroethylene as a microvascular graft in a low-pressure situation
Authors: Wong, M.T.C.
Lim, J.
Chye, L.T. 
Keywords: Low pressure
Issue Date: Jul-2007
Citation: Wong, M.T.C., Lim, J., Chye, L.T. (2007-07). Use of stretch expanded polytetrafluoroethylene as a microvascular graft in a low-pressure situation. Asian Journal of Surgery 30 (3) : 188-192. ScholarBank@NUS Repository.
Abstract: OBJECTIVE: Microvascular reconstruction is often limited by the availability and length of the pedicle. The harvesting of autologous vein grafts adds morbidity and may not provide a good match. Expanded polytetrafluoroethylene (ePTFE) grafts have been used routinely in macrovascular surgery. However, there are no conclusive data on the performance of small-diameter PTFE grafts for pedicle lengthening in free flaps in a low-pressure situation. In this study, we evaluated the efficacy of 3-mm diameter stretch ePTFE grafts to lengthen the venous pedicle of a free flap. METHODS: Fifteen male New Zealand white rabbits were operated on under sterile conditions. Using an operating microscope, an epigastric flap was raised and the pedicle was exposed and dissected to its origin from the superficial femoral vessels. A segment of the vein of 1 cm to 3 cm was replaced with a stretch ePTFE graft. Microsurgical anastomoses were performed using 9-0 nylon sutures. Four weeks postoperatively, the flaps were raised again with the pedicles re-explored. The graft was then removed and examined histologically. RESULTS: All the grafts demonstrated immediate patency. There were no cases of flap loss on the control side at 4 weeks postoperatively. When re-explored, the patent ePTFE grafts appeared to be covered by connective tissue. Light microscopy showed neoendothelialization with fibrovascular ingrowth. CONCLUSION: From this study, we can conclude that 3-mm diameter stretch ePTFE grafts can be used successfully as an alternative to bridging autologous vein grafts in free-flap pedicles. © 2007 Elsevier. All rights reserved.
Source Title: Asian Journal of Surgery
ISSN: 10159584
Appears in Collections:Staff Publications

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