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Experimental Use of Autogenous Skin for Restoration of Aortic Continuity

Experimental Use of Autogenous Skin for Restoration of Aortic Continuity Abstract The rapid advances in vascular surgery during the past decade were in great part due to the introduction into clinical surgery of vascular replacements. During this period of time, experience and long-term experimental studies1 of preserved homologous tissue revealed a marked degree of thinning and calcific degeneration, and, in some instances, aneurysm formation or even rupture. In peripheral vessels, previous experience with autogenous vein grafts had led some investigators to evaluate autogenous vein grafts in the aorta of animals, with or without external reinforcement2-6 but the results indicated that such replacements would be unsafe in the aorta of human patients. These studies being reported represent an evaluation of another readily available autogenous tissue with significant strength and elasticity, namely, skin. These experiments, begun at Columbia University in 1951, were repeated independently in the surgical laboratories of Baylor University, and the joint findings form the basis for this report. References 1. Coleman, C. C., Jr.; Deterling, R. A., Jr., and Parshley, M. S.: Some Long-Term Observations on Aortic Homografts , Surgery 37:64-79, 1955. 2. Johnson, J.; Kirby, C. K.; Greifenstein, F. E., and Castillo, A.: The Experimental and Clinical Use of Vein Grafts to Replace Defects in Large Arteries , Surgery 26:945-956, 1949. 3. Shumacker, H. B., Jr.; Schloss, G.; Freeman, L. W.; Wayson, E. E., and Stahl, N. H.: Studies in Vascular Repair: V. Experiments with the Use of Free Venous Transplants for Bridging Aortal Defects , Yale J. Biol. & Med. 23:81-93, 1950. 4. Macpherson, A. I. S.; Nabatoff, R. A.; Deterling, R. A., Jr., and Blakemore, A. H.: Observations on the Use of Preserved Venous Homografts in Experimental Aortic Defects , A.M.A. Arch. Surg. 63:152-161, 1951. 5. Sako, Y.: Prevention of Dilatation of Autogenous Venous and Pericardial Grafts in the Thoracic Aorta , Surgery 30:148-160, 1951. 6. Vargas, L. L., and Deterling, R. A., Jr.: The Use of Nylon Net for the External Support of Blood Vessel Grafts and Aneurysms , Surgery 34:1061-1075, 1953. 7. Mair, G. B.: Use of Whole Skin Grafts as Substitute for Fascial Sutures: Preliminary Report , Brit. J. Surg. 32:381-385, 1945 8. Am. J. Surg. 69:352-365, 1945. 9. Shaffer, J. O.: Dermal Grafts in the Repair of Massive Abdominal Hernias , Am. Surgeon 18:372, 1952. 10. Gebauer, P. W.: Further Experiences with Dermal Grafts for Healed Tuberculous Stenosis of Bronchi and Trachea , J. Thoracic Surg. 20:628-647, 1950. 11. Gebauer, P. W.: Plastic Reconstruction of Tuberculous Bronchostenosis with Dermal Grafts , J. Thoracic Surg. 19:604-628, 1950. 12. Gebauer, P. W.: Reconstructive Surgery of Trachea and Bronchi: Late Results with Dermal Grafts , J. Thoracic Surg. 22:538-541, 1952. 13. Gebauer, P. W.: Use of Dermal Grafts for Tuberculous Stenosis of Trachea and Bronchi , Hawaii M.J. 8:413-418, 1949. 14. Geever, E. D., and Merendino, K. A.: Repair of Diaphragmatic Defects with Cutis Grafts: Experimental Study , Surg. Gynec. & Obst. 95:308-316, 1952. 15. Lowenberg, E. L.: Aneurysm of the Abdominal Aorta: Report of 2 Cases Treated by Cutis Grafting , Angiology 1:396, 1950. 16. Hardin, C. A.: Dermal Grafts in the Experimental Repair of Vascular Defects , Angiology 6:47-51, 1955. 17. Fisher, B.; Rosencrans, D.; Adams, C., and Fisher, E. R.: The Fate of Autogenous Skin Tubes as Aorta Grafts , Surg. Gynec. & Obst. 102:309, 1956. 18. Horton, C. E.; Campbell, F.; Connar, R.; McWhirt, J., and Pickrell, K.: Behavior of Split-Thickness, Dermal, and Full-Thickness Skin Grafts in Thoracic Cavity , A.M.A. Arch. Surg. 70:221-228, 1955. 19. Kittle, C. F., and Taquechel, C. E.: A Preliminary Investigation of Dermal Heterografts (Leather) as Prostheses for Vascular Defects , A.M.A. Arch. Surg. 74:96-104, 1957. 20. Wagner, M.; Benjamin, H. B.; Zeit, W., and Kuzma, J. F.: The Autoplastic Cutis Vascular Graft , A.M.A. Arch. Surg. 77:652-654, 1958. 21. Wagner, M.; Benjamin, H. B.; Zeit, W., and Kuzma, J. F.: Autoplastic Cutis Vascular Grafts; Report on Histological Study , Transpl. Bull. 5:5-9, 1958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Experimental Use of Autogenous Skin for Restoration of Aortic Continuity

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Publisher
American Medical Association
Copyright
Copyright © 1960 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1960.01290190054011
Publisher site
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Abstract

Abstract The rapid advances in vascular surgery during the past decade were in great part due to the introduction into clinical surgery of vascular replacements. During this period of time, experience and long-term experimental studies1 of preserved homologous tissue revealed a marked degree of thinning and calcific degeneration, and, in some instances, aneurysm formation or even rupture. In peripheral vessels, previous experience with autogenous vein grafts had led some investigators to evaluate autogenous vein grafts in the aorta of animals, with or without external reinforcement2-6 but the results indicated that such replacements would be unsafe in the aorta of human patients. These studies being reported represent an evaluation of another readily available autogenous tissue with significant strength and elasticity, namely, skin. These experiments, begun at Columbia University in 1951, were repeated independently in the surgical laboratories of Baylor University, and the joint findings form the basis for this report. References 1. Coleman, C. C., Jr.; Deterling, R. A., Jr., and Parshley, M. S.: Some Long-Term Observations on Aortic Homografts , Surgery 37:64-79, 1955. 2. Johnson, J.; Kirby, C. K.; Greifenstein, F. E., and Castillo, A.: The Experimental and Clinical Use of Vein Grafts to Replace Defects in Large Arteries , Surgery 26:945-956, 1949. 3. Shumacker, H. B., Jr.; Schloss, G.; Freeman, L. W.; Wayson, E. E., and Stahl, N. H.: Studies in Vascular Repair: V. Experiments with the Use of Free Venous Transplants for Bridging Aortal Defects , Yale J. Biol. & Med. 23:81-93, 1950. 4. Macpherson, A. I. S.; Nabatoff, R. A.; Deterling, R. A., Jr., and Blakemore, A. H.: Observations on the Use of Preserved Venous Homografts in Experimental Aortic Defects , A.M.A. Arch. Surg. 63:152-161, 1951. 5. Sako, Y.: Prevention of Dilatation of Autogenous Venous and Pericardial Grafts in the Thoracic Aorta , Surgery 30:148-160, 1951. 6. Vargas, L. L., and Deterling, R. A., Jr.: The Use of Nylon Net for the External Support of Blood Vessel Grafts and Aneurysms , Surgery 34:1061-1075, 1953. 7. Mair, G. B.: Use of Whole Skin Grafts as Substitute for Fascial Sutures: Preliminary Report , Brit. J. Surg. 32:381-385, 1945 8. Am. J. Surg. 69:352-365, 1945. 9. Shaffer, J. O.: Dermal Grafts in the Repair of Massive Abdominal Hernias , Am. Surgeon 18:372, 1952. 10. Gebauer, P. W.: Further Experiences with Dermal Grafts for Healed Tuberculous Stenosis of Bronchi and Trachea , J. Thoracic Surg. 20:628-647, 1950. 11. Gebauer, P. W.: Plastic Reconstruction of Tuberculous Bronchostenosis with Dermal Grafts , J. Thoracic Surg. 19:604-628, 1950. 12. Gebauer, P. W.: Reconstructive Surgery of Trachea and Bronchi: Late Results with Dermal Grafts , J. Thoracic Surg. 22:538-541, 1952. 13. Gebauer, P. W.: Use of Dermal Grafts for Tuberculous Stenosis of Trachea and Bronchi , Hawaii M.J. 8:413-418, 1949. 14. Geever, E. D., and Merendino, K. A.: Repair of Diaphragmatic Defects with Cutis Grafts: Experimental Study , Surg. Gynec. & Obst. 95:308-316, 1952. 15. Lowenberg, E. L.: Aneurysm of the Abdominal Aorta: Report of 2 Cases Treated by Cutis Grafting , Angiology 1:396, 1950. 16. Hardin, C. A.: Dermal Grafts in the Experimental Repair of Vascular Defects , Angiology 6:47-51, 1955. 17. Fisher, B.; Rosencrans, D.; Adams, C., and Fisher, E. R.: The Fate of Autogenous Skin Tubes as Aorta Grafts , Surg. Gynec. & Obst. 102:309, 1956. 18. Horton, C. E.; Campbell, F.; Connar, R.; McWhirt, J., and Pickrell, K.: Behavior of Split-Thickness, Dermal, and Full-Thickness Skin Grafts in Thoracic Cavity , A.M.A. Arch. Surg. 70:221-228, 1955. 19. Kittle, C. F., and Taquechel, C. E.: A Preliminary Investigation of Dermal Heterografts (Leather) as Prostheses for Vascular Defects , A.M.A. Arch. Surg. 74:96-104, 1957. 20. Wagner, M.; Benjamin, H. B.; Zeit, W., and Kuzma, J. F.: The Autoplastic Cutis Vascular Graft , A.M.A. Arch. Surg. 77:652-654, 1958. 21. Wagner, M.; Benjamin, H. B.; Zeit, W., and Kuzma, J. F.: Autoplastic Cutis Vascular Grafts; Report on Histological Study , Transpl. Bull. 5:5-9, 1958.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Feb 1, 1960

References