The overlay autogenous tissue (OAT) patch to control major intraoperative vascular injury in an ovine model

Abstract

Objective. Iatrogenic surgical injury to large blood vessels in the abdomen or pelvis is a rare adverse event but may be lethal. We present a new technique to repair serious vascular injury using a free graft of omentum or fascia as an overlay autogenous tissue (OAT) patch. Methods. Repair to venous and arterial defects was made using an OAT patch of omentum or rectus abdominis sheath sutured through the patch and the adventitia of the injured vessel at four sites. The technique was tested in 33 repairs in an experimental sheep model. Results. Thirty-three patch repairs were attempted and all were successfully completed. Twenty-one (64%) patches were controlled by the patch alone, and adjuvant local pressure was required in 12 (36%) cases. Conclusion. We have demonstrated that an OAT patch can be used to control vascular injury in the experimental sheep model. This technique may be useful to all surgeons especially those operating in the pelvis where there may be restricted access to repair vascular injury.