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Eur J Cardiothorac Surg 1998;13:259-265
© 1998 Elsevier Science NL

Tissue response to biomaterials used for staple-line reinforcement in lung resection

A comparison between expanded polytetrafluoroethylene and bovine pericardium¹

^a Cardiothoracic and Vascular Surgeons, Ltd, 6036 North 19th Avenue, Suite 405, Phoenix, AZ 85015, USA
^b W.L. Gore Associates, Inc, Flagstaff, AZ 86002, USA

Received 1 October 1997; received in revised form 29 December 1997; accepted 14 January 1998.

Corresponding author. Tel.: +1 602 2421200; fax: +1 602 2420267.

Objective: A study in a canine model of lung-reduction surgery evaluated the tissue response to polytetrafluoroethylene (ePTFE) and bovine pericardium (BP) used for staple-line reinforcement. Methods: In each of ten dogs, BP was placed in one lung and ePTFE in the other. The implants were retrieved at 30, 95, or 167 days after implantation and studied histologically. The connective tissue covering the implants was measured and analysis of variance was used to compare results with the two materials. Results: At 30 days, the BP specimens showed focal chronic inflammation and thin tissue coverage, whereas the ePTFE specimens had no focal inflammation and thick tissue coverage. At 95 and 167 days, the inflammation in the BP specimens had resolved, but tissue coverage remained minimal, and there was no resorption of the BP. In the ePTFE specimens, tissue coverage had increased. Analysis of variance comparing representative tissue specimens showed that the tissue encapsulating the ePTFE was significantly thicker than that surrounding the BP (P<0.0001). No air leaks, staple-line disruptions, or infections occurred in the study. Conclusions: Neither ePTFE nor BP is resorbable. Both materials have been used successfully, without resultant infections, for clinical staple-line reinforcement. The more favorable tissue response to ePTFE observed in this study may have clinical ramifications. Comparative clinical studies of the two materials are needed.

Key Words: Bovine pericardium • Expanded polytetrafluoroethylene • Lung-volume reduction • Histopathology • Surgical stapling

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