Kadoba K, Schoen F J, Jonas R A
Department of Cardiac Surgery, Children's Hospital, Boston, MA 02115.
J Thorac Cardiovasc Surg. 1992 Jun;103(6):1059-67.
Two high-porosity knitted Dacron vascular grafts sealed with aldehyde cross-linked gelatin or albumin were compared with respect to the following characteristics. Porosity control by the absorbable sealant was assessed with a water porosity meter at 120 mm Hg pressure. Ease of suturing was determined by an objective needle penetration test. Sealant resorption was assessed histologically in a subcutaneous immature rat model as well as in circulatory implants. Gross and microscopic healing characteristics were compared in circulatory implants in the thoracic aorta of sheep with use of a composite conduit in every animal, which allowed direct comparison of the two graft materials and minimized differences in healing between individual animals. Both grafts demonstrated excellent porosity control and better handling characteristics than woven Dacron. Sealant resorption was generally rapid, although residual albumin sealant was often seen adjacent to anastomoses. Residual sealant appeared to result in focally poor healing with focal loss of adhesion of surrounding tissue to graft. We conclude that details of sealant preparation and application can importantly influence the performance of presealed knitted Dacron grafts and should be carefully evaluated in the laboratory before clinical implantation is begun.
将两种用醛交联明胶或白蛋白密封的高孔隙率针织涤纶血管移植物在以下特性方面进行了比较。用吸水孔隙率计在120毫米汞柱压力下评估可吸收密封剂对孔隙率的控制。通过客观的针刺试验确定缝合的难易程度。在皮下未成熟大鼠模型以及循环植入物中通过组织学评估密封剂的吸收情况。在绵羊胸主动脉的循环植入物中,使用复合导管对每只动物进行大体和微观愈合特性的比较,这使得能够直接比较两种移植物材料,并最大限度地减少个体动物之间愈合的差异。与机织涤纶相比,两种移植物均表现出出色的孔隙率控制和更好的操作特性。密封剂的吸收通常很快,尽管在吻合口附近经常可见残留的白蛋白密封剂。残留密封剂似乎导致局部愈合不良,周围组织与移植物的粘连局部丧失。我们得出结论,密封剂制备和应用的细节可对预密封针织涤纶移植物的性能产生重要影响,在开始临床植入前应在实验室中仔细评估。