Prosthetic Graft Patency in the Setting of a Polymicrobial Infection in Swine (Sus scrofa)

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• 作者：Mamie C. Stull¹ ; ² ; ^{mamiestull@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Michael S. Clemens¹ ; ² ; Thomas A. Heafner¹ ; John Devin B. Watson¹ ; Zachary M. Arthurs¹ ; Brandon W. Propper¹
• 刊名：Annals of Vascular Surgery
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：36
• 期：Complete
• 页码：265-272
• 全文大小：1448 K

文摘

In the setting of vascular injury, vein interposition graft is the preferred conduit, but may have limited availability. This study seeks to develop a large animal model assessing the graft performance of polytetrafluoroethylene (PTFE) and Dacron in the setting of a polymicrobial infection.

Methods

Thirty-seven animals were placed into 4 groups for a 21-day survival period. Six-millimeter PTFE or Dacron interposition grafts were placed in the right iliac artery with a standardized bacterial inoculation. Native vessel with and without contamination served as control groups. The inoculant was 1 × 10⁷ of genetically labeled Pseudomonas aeruginosa and Staphylococcus aureus. The primary end points were graft patency (determined by duplex ultrasound and necropsy) and graft infection (culture with molecular analysis). Secondary end points included physiological measurements, blood cultures, laboratory data, and histopathology.

Results

PTFE and Dacron had similar infection rates of 85.7% and 75%, respectively. There was no significant difference in infectious organisms between graft materials. PTFE and Dacron exhibited bacterial ingrowth and transmigration to the intraluminal portion of the conduit. Forty-five percent of the Dacron group and 40% of the PTFE group remained patent at postoperative day 21 (P = 0.98). Clinical data, including white blood cell count, percent neutrophils, and lactate, did not vary significantly between groups.

Conclusions

PTFE and Dacron perform similarly in terms of infection rates and graft failure as both have a propensity toward bacterial ingrowth and occlusion when compared with controls. This is a valid animal model to assess graft performance in the setting of polymicrobial infection and provides an avenue for studying novel prosthetic conduits.