Dura versus Gore-Tex as an abdominal wall prosthesis in an open and closed infected model

Occasionally, it is necessary to use prosthetic material to close large abdominal wall defects in infected, potentially infected, or open wounds. We compared the effectiveness of Gore-Tex (PTFE, W.L. Gore & Associates, Flagstaff, AZ) and dura for closing large, full thickness abdominal wall defects in terms of resistance to infection, patch separation, and intraperitoneal adhesion formation. Ninety guinea pigs had full thickness, 2 cm2, abdominal defects patched with either PTFE or dura. The skin was (A) left open (B) closed over the patch under aseptic conditions, or (C) closed after wound contamination with 10(5) CFU of staphylococcus aureus. Wounds were examined daily and the wound and peritoneal cavity examined at necropsy (day 45). Patch separation, patch retention, and adhesions were similar in both open (A), and clean closed (B) wounds patched with PTFE or dura. In the infected closed wounds (C) of the PTFE animals, the incision remained intact significantly longer, the time of patch separation and overall patch retention were significantly increased, and bowel adhesions were significantly reduced compared to dura animals.