Expanded Microporous Polytetrafluoroethylene (PTFE) Grafts in Contaminated Wounds

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Abstract
A clinical instance of life-threatening hemorrhage from an infected disrupted vein graft stimulated a study in dogs, comparing vein and PTFE [polytetrafluoroethylene] graft performance in wounds contaminated with Staphylococcus aureus and Escherichia coli cultured from the patient''s wound. Infective disruption of vein wall occurred in 3 of 10 animals resulting in exsanguination and death. Host artery disruption at PTFE suture line occurred in 1 of 10 animals. Thrombosis of graft and host artery in this animal precluded hemorrhage and death. This led to favorable clinical experiences with PTFE grafts in contaminated wounds of 22 trauma patients. Thus, PTFE is better assurance against disruption and hemorrhage than vein graft in contaminated, potentially infected sites. PTFE may be used preferentially as a vascular substitute in trauma patients provided that all traditional surgical safeguards and principles are followed.