Studies on Dacron Prostheses Treated with Gelatin Sponge

(1) Coarsely knitted crimped Dacron prostheses were treated with gelatin sponge with fine pores in order to obtain low porosity at the time of implantation and to allow high fibroblastic permeability through the interstices of fabrics as gelatin was absorbed in host tissue.(2) The grafts were used in the experimental replacement of the abdominal aorta in 25 dogs, in the implantation of the ascending aorta under profound hypothermia with total circulatory arrest in 8 dogs, and in the inferior vena caval (infrarenal) replacement in 8 dogs. As a control, the untreated grafts were implanted into the abdominal aorta in 18 dogs.(3) In the abdominal aortic replacement, there was no remarkable difference between the patency rate of the gelatin-treated grafts and that of the untreated ones. The inner surface of the graft was covered with thin and smooth membrane, and the outer coat of fibrous tissue adhered firmly to the graft. Histologic study revealed no delay of organization of the graft. In 3 to 4 weeks, there was nearly complete absorption of gelatin which allowed fibroblastic ingrowth through the interstices. The inner layer of the graft could be lined with the endothelium to its entire length.(4) Of 8 dogs submitted to the implantation into the ascending aorta, 4 survived operation. The graft could be used safely even though heparin was administered.(5) There were no patent grafts which were obtained from the inferior vena cava.(6) Advantages and disadvantages of the gelatin-treated graft and importance of this kind of graft that is neither plastic nor protein were discussed.(7) The gelatin-treated grafts were applied for clinical use in the treatment of 5 cases of the coarctation of the aorta, 4 cases of the abdominal aortic aneurysm, 3 cases of occlusive disease, and 1 case of arteriovenous fistula. Patients were followed for a period of 1 month to 1 year and 2 months. It had been proved entirely satisfactory in the treatment of aortic and to a less extent, of peripheral lesions.