Seromuscular enteric pedicles and prosthetic aortic graft complications ina porcine abdominal trauma model - An experimental study

Background/Aims: Abdominal vascular trauma may require prosthetic grafting despite peritoneal contamination by concurrent visceral injury. This study tested the use of vascularized, seromuscular enteric pedicles (VSEP) agains t the development of vascular prosthetic complications, in a porcine abdomi nal trauma model. Methods: Eight pigs underwent aortic transection and reco nstruction with a Dacron interposition graft (DIG). A standard bacterial in oculum soaked the DIG in situ. An enteric segment was isolated on its mesen teric pedicle, and the mucosa stripped. This VSEP was wrapped around the DI G and oversewn. Animals received antibiotics for 5 days. Endpoints were 2-w eek survival, or evidence of sepsis, The animals underwent explantation of the DIG, VSEP, and native aorta for the purposes of histological, and micro biological analyses, and scanning electron microscopy (SEM). Outcome measur es were graft infection, graft thrombosis, tissue incorporation, and anasto motic integrity. Results: Two pigs were excluded for perioperative death. A ll study group animals (n = 6), survived 2 weeks. Infection and thrombosis were found in 0/6 (0%). Incorporation and anastomotic integrity were eviden t in 6/6 (100%). VSEP had intact blood supplies. SENT demonstrated viable m uscle, microcirculation, and fibroplasia in VSEP. Conclusion: We conclude t hat VSEP may help prevent prosthetic graft complications in the contaminate d setting. Copyright (C) 2000 S. Karger AG, Basel.