Teflon-felt grafting of giant gastroduodenal perforation in a canine model.

Abstract

Giant gastroduodenal perforations involving fragile and inflammatory surrounding tissue are difficult to repair with primary closure, which often results in suture tension, gastric outlet obstruction, or reperforation. However, it is still unclear if Teflon-felt can be used to effectively repair a fragile and giant gastroduodenal defect. We made a 3.2 x 1.8-cm perforation in the gastroduodenal wall of seven adult mongrels, then grafted the defect with Teflon-felt secured with silk sutures 4 h later. Postoperatively, the dogs were fed as usual, then killed 3, 6, and 12 weeks after surgery. The results of the repair were examined carefully. Grafting Teflon-felt onto the giant perforations was easy to perform. Six dogs survived the operation without suffering gastric outlet obstruction, infection, or fistula formation. By the time they were killed, the dogs had lost 18%-23% of their body weight. Gross and microscopic examinations showed that the outer surface of the Teflon-felt graft was covered with omentum and fibrosis, and the undersurface was covered with slowly proliferating gastric mucosa. Teflon-felt appears to be a viable alternative for the delayed repair of giant ulcer perforation.