Healing Characteristics of a New Silver-Coated, Gelatine Impregnated Vascular Prosthesis in the Porcine Model

Abstract

No disadvantage of the silver coating in terms of healing and graft patency was found. A possible advantage in terms of the antibacterial effect of the silver coating must be investigated in the clinical setting.

Prosthetic vascular grafts: Wrong models, wrong questions and no healing

“…Until 10 years ago, approximately 90% of prostheses in large animal models were as short as 5.571.2 cm (Dacron and expended polytetrafluoroethylene (ePTFE)) and 4.571.7 cm polyurethanes (PU), with a median implantation periods of 91.8717.3 days for Dacron grafts, 60.079.36 days for polytetrafluoroethylene (PTFE) grafts [11] and 907127.1 days for PU grafts. In more recent years, slightly longer grafts were implanted (64% were still shorter than 7 cm) and observation periods became shorter (medians: 28.078.9 and 14.0718.7 for ePTFE and Dacron, respectively) [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. In the small proportion of studies where truly long prostheses were implanted, they were either aorto-aortic [30][31][32][33][34][35], aorto-iliac [36][37][38][39] or aorto-femoral [40].…”

In vitro evaluation of the antimicrobial efficacy of a new silver-triclosan vs a silver collagen-coated polyester vascular graft against methicillin-resistant Staphylococcus aureus

“…In recent decades, various concepts for antimicrobial grafts have been developed to prevent vascular graft infection. [21][22][23][24] However, demonstration of the clinical efficacy of antimicrobial graft material remains difficult because of the low incidence of vascular graft infection.…”

Results from the International Silver Graft Registry for high-risk patients treated with a metallic-silver impregnated vascular graft

“…This prosthesis was originally designed for prophylactic use to prevent graft infections. Sustained bactericidal effects have been confirmed in vitro 2 and in animal studies 3 with long-term studies indicating a residual graft surface silver content of 98% after 12 months. 2 Further properties relative to inhibition of bacterial growth on the surface of this silver-coated grafts have been described by Strathman et al 4 The full range of SG was available to all investigators and included bifurcations (14 × 7, 16 × 8, 18 × 9, 20 × 10) and straight tubes ranging from 6 to 20 mm in various lengths from 15 to 80 cm.…”