Thoracoabdominal wall repair with glutaraldehyde-preserved bovine pericardium.
Glutaraldehyde-preserved bovine pericardium (GPBP) is evaluated as a bioprosthesis for the reconstruction of surgical defects in the thoracoabdominal wall. The mechanical properties of bovine pericardium preserved at different concentrations of glutaraldehyde were studied. Samples preserved in 0.5% glutaraldehyde showed a significantly higher tensile strength (11.7 +/- 0.8 N/mm2) than samples preserved in 2.5, 5, or 10% (similar to pericardium preserved in normal saline). The percentage of elongation was significantly lower than samples preserved in 1, 2.5, and 5% glutaraldehyde. GPBP at 0.5% was used to repair experimentally induced defects of the abdominal wall (n = 9), chest wall (n = 6), diaphragm (n = 6), and sternum (n = 7). All animals presented adequate tolerance to the material used and no case of infection or rejection of the material was seen in any of the animals. Finally, 0.5% GPBP was used clinically in a series of 40 patients: postincisional abdominal hernia (n = 30), inguinal hernia (n = 8), diaphragmatic hernia (n = 1), and congenital pelvic defect with prolapse of abdominal organs (n = 1). Surgical use showed that GPBP was a very manageable material and long-term results were good in 37 patients with a mean follow up of 18 months (range 5-35 months). Six patients presented seroma formation (all abdominal hernia patients), three of which eventually developed infection and had the GPBP patch removed at 3, 5, and 7 months postoperatively. The rest of the patients presented good scar formation with adequate resistance at the area of implantation. GPBP is a biological material with sufficient resistance to be used surgically in the repair of thoracoabdominal defects. Ideal concentration of glutaraldehyde to be used in the preparation-preservation of the material is 0.5% since higher concentration negatively affect its tensile rupture strength and elongation.
Santillan-Doherty
P
P
Department of Experimental Surgery, National Institute of Respiratory Diseases, Tlalpan, Mexico.
Jasso-Victoria
R
R
Sotres-Vega
A
A
Olmos
R
R
Arreola
J L
JL
Garcia
D
D
Vanda
B
B
Gaxiola
M
M
Santibañez
A
A
Martin
S
S
Cabello
R
R
D000009:Abdominal Muscles / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002417:Cattle; D002648:Child; D002675:Child, Preschool; D003964:Diaphragm / Q000601:surgery; D004285:Dogs; D005260:Female; D005976:Glutaral; D059685:Herniorrhaphy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D010496:Pericardium / Q000637:transplantation*; D010532:Peritoneal Diseases / Q000209:etiology; D013718:Tensile Strength; D013903:Thoracic Surgery / Q000379:methods*; D000267:Tissue Adhesions / Q000209:etiology; D014021:Tissue Preservation / Q000379:methods
D005976:Glutaral