Delayed repair of duodenal defect with the use of Small Intestinal Submucosa patch

• Published in: Hellenic journal of surgery Vol. 83; no. 2; pp. 67 - 71
• Main Authors: Trygonis, S., Trygonis, C., Miliaras, D., Kiskinis, D.
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01-04-2011
• Subjects: Experimental Study; Medicine; Medicine & Public Health; Surgery; Duodenal Injury; Small Intestinal Submucosa; Mucosal regeneration
• ISSN: 0018-0092; 1868-8845
• DOI: 10.1007/s13126-011-0013-6

Aim
Duodenal injuries, though rare, carry high rates of morbidity and mortality. Our purpose was to evaluate the healing of the second portion of the duodenal wall with the use of the Small Intestinal Submucosa (S. I. S) patch.
Methods
We studied 40 Whistar-Albino rats divided into two groups of 20 animals each. In Group A, we created a small defect in the duodenal wall which was immediately covered with a SurgiSIS® patch. In group B, the SurgiSIS® patch was sutured over the defect after 6–8 hours, in order to induce peritonitis, mimicking the delayed management of the duodenal trauma, which is common in everyday practice. The animals of both groups were sacrificed after 2, 6, 12 and 16 weeks respectively and were examined both macroscopically and pathologically in order to define the degree of coverage of the defect by the patch and the development of new duodenal wall over the patch.
Results
Three animals died postoperatively due to surgical complications. In the remaining 37, as well as the three dead animals, the SurgiSIS® patch covered and completely sealed the defect of the duodenal wall. Pathologic examination showed progressive development of the layers of the duodenal wall over the patch as early as the 2nd week in some of the animals of group A. Mucosa developed among those in group B in the 6th week, probably a consequence of inflammation deriving from peritonitis.
Conclusion
The SurgiSIS® patch is both efficient and safe for the management of duodenal trauma.