The overlay autogenous tissue (OAT) patch to control major intraoperative vascular injury in an ovine model.
OBJECTIVE
Iatrogenic surgical injury to large blood vessels in the abdomen or pelvis is a rare adverse event but may be lethal. We present a new technique to repair serious vascular injury using a free graft of omentum or fascia as an overlay autogenous tissue (OAT) patch.


METHODS
Repair to venous and arterial defects was made using an OAT patch of omentum or rectus abdominis sheath sutured through the patch and the adventitia of the injured vessel at four sites. The technique was tested in 33 repairs in an experimental sheep model.


RESULTS
Thirty-three patch repairs were attempted and all were successfully completed. Twenty-one (64%) patches were controlled by the patch alone, and adjuvant local pressure was required in 12 (36%) cases.


CONCLUSIONS
We have demonstrated that an OAT patch can be used to control vascular injury in the experimental sheep model. This technique may be useful to all surgeons especially those operating in the pelvis where there may be restricted access to repair vascular injury.
Western Australian Gynecologic Cancer Service, King Edward Memorial Hospital for Women, Subiaco, Perth 6008, Western Australia. hammond@wantree.com.au
Ian G
IG
Hammond
Andreas
A
Obermair
John D
JD
Taylor
Michael
M
Lawrence-Brown
D000818:Animals; D001808:Blood Vessels / Q000293:injuries*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D007431:Intraoperative Complications / Q000601:surgery; D023421:Models, Animal; D009852:Omentum / Q000637:transplantation; D017568:Rectus Abdominis / Q000637:transplantation; D012756:Sheep; D019737:Transplants; D014656:Vascular Surgical Procedures / Q000379:methods*