Use of polytetrafluoroethylene patch for temporary wound closure after pediatric liver transplantation

David S. Seaman, Kenneth A. Newell, James B. Piper, David S. Bruce, E. Steve Woodle, David C. Cronin, Estella M. Alonso, Peter F. Whitington, J. Richard Thistlethwaite, J. Michael Millis*

*Corresponding author for this work

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Despite numerous options for pediatric transplantation, closure of the abdominal wall after liver transplantation is occasionally difficult, resulting in increased abdominal pressure and possible vascular compromise. Since 1990, we have utilized a 2-mm thick sheet of polytetrafluoroethylene (PTFE) to overcome this situation in 21 transplants for 17 patients. The median age was 0.9 months. Ten of the 21 transplants utilized full-size grafts. The donor to recipient weight ratio was 1.7±1.2. Cadaveric left lateral segments were used in 8 of 21 transplants (weight ratio, 7.4±5.9), living donor left lateral segments were used in 3 of 21 transplants (weight ratio, 13.2±6.7). We were able to remove 14 of 21 patches with one additional operation, whereas 4/21 patches required two operations and 3/21 required three operations. Reoperations identified two cases of hepatic artery thrombosis not previously identified by duplex ultrasonography. There were no technical problems or adverse effects associated with the use of the PTFE patch. After patch removal, the fascia was closed with a nonabsorbable suture and the skin was allowed to close by secondary intention. There were no wound infections, portal vein thrombosis, or fluid and electrolyte abnormalities. PTFE is a safe, temporary alternative to primary wound closure in liver transplantation when the size of the graft or intestinal and graft edema does not allow conventional closure of the abdomen. Infectious, fluid/electrolyte, or ventilatory complications were not noted. The necessity of a second-look operation is useful in assessing the graft and vascular patency. The majority of patches can be removed within the first postoperative week.

Original languageEnglish (US)
Pages (from-to)1034-1036
Number of pages3
JournalTransplantation
Volume62
Issue number7
DOIs
StatePublished - Oct 15 1996

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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    Seaman, D. S., Newell, K. A., Piper, J. B., Bruce, D. S., Woodle, E. S., Cronin, D. C., Alonso, E. M., Whitington, P. F., Thistlethwaite, J. R., & Millis, J. M. (1996). Use of polytetrafluoroethylene patch for temporary wound closure after pediatric liver transplantation. Transplantation, 62(7), 1034-1036. https://doi.org/10.1097/00007890-199610150-00027