ABSTRACT
Vascular prostheses of small diameter perform poorly in vivo, in part because of the high thrombogenicity of available biomaterials. This study examined the thrombogenicity of expanded polytetrafluoroethylene (ePTFE) vascular graft segments (10 mm long x 4 mm i.d.) in vitro before and after impregnation with saline, alginate, or alginate containing the stable prostacyclin analog, iloprost. Each segment was immersed in activated whole blood and the weight of the adherent thrombus was measured at specified intervals. At 6 and 7 min the saline-denucleated group accumulated significantly less thrombus than control (p < .05). Alginate alone was not significantly different from controls. The graft segments treated with alginate + iloprost accumulated significantly less thrombus (p < .05) than all other groups after 6 min. These data demonstrate that denucleation of ePTFE with iloprost in alginate dramatically decreases its in vitro thrombogenicity.
Subject(s)
Alginates , Biocompatible Materials , Graft Occlusion, Vascular/prevention & control , Iloprost , Platelet Aggregation Inhibitors , Polytetrafluoroethylene , Thrombosis/prevention & control , Blood Vessel Prosthesis , Glucuronic Acid , Hexuronic Acids , HumansABSTRACT
There is little mention in the literature of the outcome of patients who require amputations for large surface area burns. To determine their outcome, we devised a case-control study. Fifteen patients who underwent amputations between 1984 and 1993 at the University of Louisville Burn Unit were analysed and compared to a similarly injured control group. Both groups represented severely burned patients with high total body surface areas involvement. Apache II scores, and per cent of inhalation injuries. The results showed a 60 per cent survival rate in each group. Unlike previous reports on electrical burns, the amputations in this series of primarily thermal injuries (12 of 15 patients) were performed late in the hospital course (mean, 15 days) and after previous attempts at limb salvage (mean, two procedures). By eliminating either non-viable or infected tissue, amputations served a role in obtaining a respectable survival rate for these severely injured patients that also compared favourably with the control group.
