Repair of Large Abdominal Wall Defects with Expanded Polytetrafluoroethylene (PTFE)

Abstract

Most abdominal wall incisional hernias can be repaired by primary closure. However, where the defect is large or there is tension on the closure, the use of a prosthetic material is indicated. Expanded polytetrafluoroethylene (PTFE) patches were used to repair incisional hernias in 28 patients between November 1983 and December 1986. Twelve of these patients (43%) had a prior failure of a primary repair. Reherniation occurred in three patients (10.7%). Wound infections developed in two patients (7.1%), both of whom had existing intestinal stomas, one with an intercurrent pelvic abscess. The prosthetic patch was removed in the patient with the abscess, but the infection was resolved in the other without sequelae. Septic complications did not occur after any operations performed in uncontaminated fields. None of the patients exhibited any undue discomfort, wound pain, erythema, or induration. Complications related to adhesions, erosion of the patch material into the viscera, bowel obstruction, or fistula formation did not occur. Based on this clinical experience, the authors believe that the PTFE patch appears to represent an advance in synthetic abdominal wall substitutes.

Acellular dermal graft for repair of abdominal wall defects in rabbits

“…Mild swelling, pain, warmth and exudation were observed in both groups. The presence of swelling at the site may be attributed to inflammation in response to surgical trauma 3,10 . As the healing progressed, the inflammation subsided gradually and no exudation or warmth was observed in any animal from day 6 onwards.…”

Expanded polytetrafluoroethylene membrane for the prevention of peridural fibrosis after spinal surgery: a clinical study

“…No clinical experience with any of these agents has been reported. Expanded polytetrafluoroethylene, a biocompatible material, has been used safely and effectively for many years in multiple clinical applications in several surgical areas, including vascular surgery [19,22,27], soft-tissue repair [3], plastic surgery [23], gynaecology [5], cardiac surgery [14] and neurosurgery [13,33]. In long-term follow-up on patients in whom an ePTFE membrane [3,10,27,33] was implanted, the presence of wear debris was not shown; similarly, the implantation of this membrane in the defect of a rachidial laminectomy is not submitted to the same shear forces that prosthetic articular implants are.…”

Escolha do material da tela para disposição intra-peritoneal na correção cirúrgica de defeitos herniários da parede abdominal

“…Estes valores variam de casuística para casuística, mas supõe-se que o uso de telas reduz a formação de hérnia incisional de cerca de 30-40% 2,18 para 5-10% 11 . Conforme vários autores, dentre as próteses sintéticas atualmente disponíveis em nosso meio, a tela de polipropileno ainda é o material mais utilizado 2,13,16,17,24 . O uso intra-abdominal de telas, contudo, tem indicações restritas, pois a colocação intra-peritoneal destas próteses apresenta complicações, podendo cursar com a formação de aderências, fístulas êntero-cutâneas 9,11,12,13,14,18,23 e até mesmo oclusão intestinal 11,13,18,23 , sendo esta última, a complicação mais séria da formação de aderências 10,21 .…”