Viscosity characterization and flow simulation and visualization of polytetrafluoroethylene paste extrusion using a green and biofriendly lubricant.

Polytetrafluoroethylene (PTFE) and expanded PTFE (ePTFE) are ideal for various applications. Because PTFE does not flow, even when heated above its melting point, PTFE components are fabricated using a process called paste extrusion. This process entails blending PTFE powder particles with a lubricant to form PTFE paste, which is subsequently preformed, extruded, expanded (in the case of ePTFE), and sintered. In this study, ethanol was proposed as an alternative green lubricant for PTFE processing. Not only is ethanol benign and biofriendly, it provides excellent wettability and processing benefits. Using ethanol as a lubricant, the shear viscosity of PTFE paste and its flow behavior during paste extrusion were investigated. Frequency sweeps using a parallel-plate rheometer were performed on PTFE paste samples and various grits of sandpaper were used to reduce wall slip of PTFE paste. A viscosity model was generated and a multiphysics software was used to simulate PTFE paste extrusion. The simulated extrusion pressure was compared to experimental data of actual paste extrusion. Flow visualization experiments using colored PTFE layers were conducted to reveal the flow profile of the PTFE paste. The morphology of the expanded ePTFE tubes was examined using scanning electron microscopy and the effect of expansion ratio on ePTFE morphology was quantified.

TIPS for refractory ascites: a 6-year single-center experience with expanded polytetrafluoroethylene-covered stent-grafts.

OBJECTIVE. This single-center study evaluated the use of expanded polytetrafluoroethylene (ePTFE)-covered stent-grafts for transjugular intrahepatic portosystemic shunt (TIPS) placement to manage portal hypertension-related refractory ascites. MATERIALS AND METHODS. One hundred patients at a single tertiary care center in a major metropolitan hospital underwent TIPS placement with an ePTFE-covered stent-graft (Viatorr TIPS Endoprosthesis). Patients with portal hypertension-related ascites and preexisting hepatocellular carcinoma or liver transplant were excluded from the analysis. Records were reviewed for demographic characteristics, technical success of the TIPS procedures, and stent follow-up findings. Clinical results were assessed at 90- and 180-day intervals. RESULTS. Immediate technical success of the TIPS procedure was 100%. Of the 61 patients with documented follow-up, 55 (90.2%) had a partial or complete ascites response to TIPS creation. Of these 55 patients, nine experienced severe encephalopathy. Six of 61 patients (9.8%) did not experience a significant ascites response. Overall survival was 78.7% at 365-day follow-up. The 365-day survival was 84.2% for patients with a model for end-stage liver disease (MELD) score of less than 15, 67.0% for those with a score of 15-18, and 53.8% for those with a score of greater than 18 (p = 0.01). For patients with a MELD score of less than 18, the 365-day survival was 88.0% for those with an albumin value of 3 mg/dL or greater and 72.8% for those with an albumin value of less than 3 mg/dL (p = 0.04). CONCLUSION. TIPS placement using an ePTFE-covered stent-graft is an efficacious therapy for refractory ascites. Patients with preserved liver function-characterized by a MELD score of less than 15 or a MELD score of less than 18 and an albumin value of 3 mg/dL or greater-experience the greatest survival benefit.

Small diameter expanded polytetrafluoroethylene vascular graft with differentiated inner and outer biomacromolecules for collaborative endothelialization, anti-thrombogenicity and anti-inflammation.

Without differentiated inner and outer biological function, expanded polytetrafluoroethylene (ePTFE) small-diameter (<6 mm) artificial blood vessels would fail in vivo due to foreign body rejection, thrombosis, and hyperplasia. In order to synergistically promote endothelialization, anti-thrombogenicity, and anti-inflammatory function, we modified the inner and outer surface of ePTFE, respectively, by grafting functional biomolecules, such as heparin and epigallocatechin gallate (EGCG), into the inner surface and polyethyleneimine and rapamycin into the outer surface via layer-by-layer self-assembly. Fourier-transform infrared spectroscopy showed the successful incorporation of EGCG, heparin, and rapamycin. The collaborative release profile of heparin and rapamycin lasted for 42 days, respectively. The inner surface promoted human umbilical vein endothelial cells (HUVECs) adhesion and growth and that the outer surface inhibited smooth muscle cells growth and proliferation. The modified ePTFE effectively regulated the differentiation behavior of RAW264.7, inhibited the expression of proinflammatory mediator TNF-α, and up-regulated the expression of anti-inflammatory genes Arg1 and Tgfb-1. The ex vivo circulation results indicated that the occlusions and total thrombus weight of modified ePTFE was much lower than that of the thrombus formed on the ePTFE, presenting good anti-thrombogenic properties. Hence, the straightforward yet efficient synergistic surface functionalization approach presented a potential resolution for the prospective clinical application of small-diameter ePTFE blood vessel grafts.

A review of the development of interventional devices for mitral valve repair with the implantation of artificial chords.

Mitral regurgitation (MR) was the most common heart valve disease. Surgical repair with artificial chordal replacement had become one of the standard treatments for mitral regurgitation. Expanded polytetrafluoroethylene (ePTFE) was currently the most commonly used artificial chordae material due to its unique physicochemical and biocompatible properties. Interventional artificial chordal implantation techniques had emerged as an alternative treatment option for physicians and patients in treating mitral regurgitation. Using either a transapical or a transcatheter approach with interventional devices, a chordal replacement could be performed transcatheter in the beating heart without cardiopulmonary bypass, and the acute effect on the resolution of mitral regurgitation could be monitored in real-time by transesophageal echo imaging during the procedure. Despite the in vitro durability of the expanded polytetrafluoroethylene material, artificial chordal rupture occasionally occurred. In this article, we reviewed the development and therapeutic results of interventional devices for chordal implantation and discuss the possible clinical factors responsible for the rupture of the artificial chordal material.

The clinical effectiveness of staple line reinforcement with different matrix used in surgery.

Staplers are widely used in clinics; however, complications such as bleeding and leakage remain a challenge for surgeons. To tackle this issue, buttress materials are recommended to reinforce the staple line. This Review provides a systematic summary of the characteristics and applications of the buttress materials. First, the physical and chemical properties of synthetic polymer materials and extracellular matrix used for the buttress materials are introduced, as well as their pros and cons in clinical applications. Second, we review the clinical effects of reinforcement mesh in pneumonectomy, sleeve gastrectomy, pancreatectomy, and colorectal resection. Based on the analysis of numerous research data, we believe that buttress materials play a crucial role in increasing staple line strength and reducing the probability of complications, such as bleeding and leakage. However, considering the requirements of bioactivity, degradability, and biosafety, non-crosslinked small intestinal submucosa (SIS) matrix material is the preferred candidate. It has high research and application value, but further studies are required to confirm this. The aim of this Review is to provide comprehensive guidance on the selection of materials for staple line reinforcement.

Biological mechanisms of infection resistance in tissue engineered blood vessels compared to synthetic expanded polytetrafluoroethylene grafts.

Objective: Synthetic expanded polytetrafluoroethylene (ePTFE) grafts are known to be susceptible to bacterial infection. Results from preclinical and clinical studies of bioengineered human acellular vessels (HAVs) have shown relatively low rates of infection. This study evaluates the interactions of human neutrophils and bacteria with ePTFE and HAV vascular conduits to determine whether there is a correlation between neutrophil-conduit interactions and observed differences of their infectivity in vivo. Methods: A phase III comparative clinical study between investigational HAVs (n = 177) and commercial ePTFE grafts (n = 178) used for hemodialysis access (ClinicalTrials.gov Identifier: NCT02644941) was evaluated for conduit infection rates followed by histological analyses of HAV and ePTFE tissue explants. The clinical histopathology of HAV and ePTFE conduits reported to be infected was compared with immunohistochemistry of explanted materials from a preclinical model of bacterial contamination. Mechanistic in vitro studies were then conducted using isolated human neutrophils seeded directly onto HAV and ePTFE materials to analyze neutrophil viability, morphology, and function. Results: Clinical trial results showed that the HAV had a significantly lower (0.93%; P = .0413) infection rate than that of ePTFE (4.54%). Histological analysis of sections from infected grafts explanted approximately 1 year after implantation revealed gram-positive bacteria near cannulation sites. Immunohistochemistry of HAV and ePTFE implanted in a well-controlled rodent infection model suggested that the ePTFE matrix permitted bacterial infiltration and colonization but may be inaccessible to neutrophils. In the same model, the HAV showed host recellularization and lacked detectable bacteria at the 2-week explant. In vitro results demonstrated that the viability of human neutrophils decreased significantly upon exposure to ePTFE, which was associated with neutrophil elastase release in the absence of bacteria. In contrast, neutrophils exposed to the HAV material retained high viability and native morphology. Cocultures of neutrophils and Staphylococcus aureus on the conduit materials demonstrated that neutrophils were more effective at ensnaring and degrading bacteria on the HAV than on ePTFE. Conclusions: The HAV material seems to demonstrate a resistance to bacterial infection. This infection resistance is likely due to the HAV's native-like material composition, which may be more biocompatible with host neutrophils than synthetic vascular graft material.

Heparin/Collagen-REDV Modification of Expanded Polytetrafluoroethylene Improves Regional Anti-thrombosis and Reduces Foreign Body Reactions in Local Tissues.

Prosthetic implants of expanded polytetrafluoroethylene (ePTFE) in the cardiovascular system have a high failure rate over the long term because of thrombosis and intimal hyperplasia. Although multiple surface modification methods have been applied to improve the anti-thrombotic and in situ endothelialization abilities of ePTFE, none have delivered outstanding results in vivo. Our previous study combined heparin/collagen multilayers and REDV peptides to modify ePTFE, and the in-vitro results showed that modification ePTFE with heparin/collagen-REDV can promote the cytocompatibility and antiplatelet property. This study illustrated the physical change, selective endothelial cells capture ability, and in vivo performance in further. The physical test demonstrated that this modification improved the hydrophilicity, flexibility and strength of ePTFE. A competition experiment of co-cultured endothelial cells and vascular smooth muscle cells verified that the heparin/collagen-REDV modification had high specificity for endothelial cell capture. A rabbit animal model was constructed to evaluate the in vivo performance of modified ePTFE implanted in the right ventricular outflow tract. The results showed that heparin/collagen-REDV modification was safe, promoted endothelialization, and successfully achieved regional anti-thrombosis without influencing body-wide coagulation function. The pathologic manifestations and mRNA expression pattern in tissues in contact with modified ePTFE indicated that this modification method may reduce M2-type macrophage infiltration and the expression of genes related to immune and inflammatory responses. The heparin/collagen-REDV modification may lower the incidence of complications related to ePTFE implantation and has good prospects for clinical use.

Ross Procedure in the era of Handmade-Valved Conduits for Right Ventricular Outflow Tract Reconstruction in Children: Short-Term Surgical Outcomes.

Objective: Ross procedure is considered as the "gold standard" for aortic valve replacement, but the conduits used for right ventricular outflow tract (RVOT) reconstruction, such as homografts and bovine jugular vein (BJV) conduits, are of limited availability in China. Handmade expanded polytetrafluoroethylene-valved conduits (HVCs) have been used recently as the alternative for RVOT reconstruction, but their specific experience in Ross procedure is limited in the literature. Methods: This was a retrospective review of 27 children who underwent Ross procedure in our center from January 2018 to January 2022. Results: Mean age at surgery was 8.0 ± 3.8 years. During the study period, BJV conduits were used for RVOT reconstruction in 6 patients (22%), and HVCs were used in 21 patients (78%). Median conduit size was 20 mm (range, 16-24 mm), and mean conduit Z-score was +0.8 ± 0.9. Median time for cardiopulmonary bypass was 158 min (range, 109-275 min), and mean time for aortic crossclamping was 110 ± 21 min. There was no early mortality. During a median follow-up time of 1.4 years (range, 0.1-3.7 years), 3 patients (11%) with BJV conduits had peak conduit velocity of > 3.5 m/s; 3 patients (11%) with HVCs developed moderate conduit insufficiency; no patients had more than moderate conduit insufficiency. Three patients with BJV conduits had 5 reinterventions, and all received conduit replacement with HVCs. Conclusion: HVC is an appealing alternative to BJV conduit for RVOT construction for children undergoing Ross procedure, with favorable short-term outcomes.

A novel bilayered expanded polytetrafluoroethylene glaucoma implant creates a permeable thin capsule independent of aqueous humor exposure.

The purpose of these studies was to evaluate clinical, functional, and histopathological features of glaucoma drainage implants (GDIs) fabricated from novel, custom-tailored expanded polytetrafluoroethylene (ePTFE). Implants of matching footprints were fabricated from silicone (Control) and novel, bilayered ePTFE. ePTFE implants included: (a) one that inflated with aqueous humor (AH) (High), (b) one that inflated with a lower profile (Low), (c) an uninflated implant not connected to the anterior chamber (Flat), and (d) one filled with material that did not allow AH flow (Filled). All implants were placed in adult New Zealand White rabbits and followed over 1-3 months with clinical exams and intraocular pressure. The permeability of tissue capsules surrounding GDIs was assessed using constant-flow perfusion with fluoresceinated saline at physiologic flow rates. After sacrifice, quantitative histopathological measures of capsule thickness were compared among devices, along with qualitative assessment of cellular infiltration and inflammation. Capsular thickness was significantly reduced in blebs over ePTFE (61.4 ± 53 µm) versus silicone implants (193.6 ± 53 µm, p = .0086). AH exposure did not significantly alter capsular thickness, as there was no significant difference between High and Filled (50.9 ± 29, p = .34) implants. Capsules around ePTFE implants demonstrated permeability with steady-state pressure: flow relationships at physiologic flow rates and rapid pressure decay with flow cessation, while pressure in control blebs increased even at low flow rates and showed little decay. Perfused fluorescein dye appeared beyond the plate border only in ePTFE implants. ePTFE implants are associated with thinner, more permeable capsules compared to silicone implants simulating presently used devices.

Ultrasonic Welding of PBT-GF30 (70% Polybutylene Terephthalate + 30% Fiber Glass) and Expanded Polytetrafluoroethylene (e-PTFE).

The ultrasonic welding of polymeric materials is one of the methods often used in practice. However, each couple of material subjected to ultrasonic welding is characterized by different values of technological parameters. Therefore, the main objective of the research presented in this paper is to optimize the parameters for the ultrasonic welding of two materials, namely PBT-GF30 (70% polybutylene terephthalate + 30% fiber glass) and expanded polytetrafluoroethylene (e-PTFE). In this sense, the research was carried out considering a plate-type part made of PBT-GF30, which had a thickness of 2.1 mm, and a membrane-type part made of e-PTFE, with a thickness of 0.3 mm. The condition imposed on the welded joints made, namely to correspond from a technical point of view, was that the detachment pressure of the membrane should be at least 4 bar. To this end, a test device was designed. Additionally, the topography of the material layer from the plate-type part was analyzed, as well as the chemical composition and surface condition for the membrane-type part. The obtained results allowed the optimization of the following parameters: The welding force; welding time; amplitude; and holding time. All experimental results were processed using STATISTICS software, which established how each parameter influences the characteristics of welded joints.

Expanded Polytetrafluoroethylene/Graphite Composites for Easy Water/Oil Separation.

Oil spills in the ocean greatly threaten local environments, marine creatures, and coastal economies. An automatic water/oil separation material system was proposed in this study, and a tubular geometry was chosen to demonstrate the water/oil separation efficiency and effectiveness. The water/oil separation tubes were made of expanded polytetrafluoroethylene (ePTFE) and graphite composites. The permeation pressures of water and oil through the tube walls were tuned by adjusting the ePTFE microstructure, which, in turn, depended on the degree of expansion and the graphite content. Fourier-transform infrared spectroscopy was performed to confirm the compositions of the ePTFE/graphite composites, and a scanning electron microscope was used to examine the microstructure and morphology of the expanded PTFE/graphite composite tubes. When a proper pressure was applied, which was higher than the oil's permeation pressure (3.0 kPa) but lower than the water's permeation pressure (57 kPa), the oil leaked out of the tube walls while the water went through the ePTFE/graphite tubes. As such, the water/oil mixture could be separated and collected in different containers or an outer tube. Due to this automatic separation, the whole process could be done continuously and conveniently, thus exhibiting great potential in the practical applications of oil spill and water separation/remediation.

Percutaneous pulmonary debanding for an infant complicated by spontaneously closing muscular ventricular septal defect: A case report and in vitro study.

Pulmonary artery banding (PAB) is a standard operation for various congenital heart defects complicated by pulmonary hypertension (PH) and judged unsuitable for primary intracardiac repair. We report successful percutaneous pulmonary artery debanding in a baby complicated by muscular ventricular septal defect (VSD), that was initially large and multiple, but closed spontaneously later. The 5-month-old boy was referred to our hospital on day 3, diagnosed as having aortic coarctation (CoA), with multiple muscular VSDs and severe PH. On day 6, he underwent CoA repair and PAB using expanded polytetrafluoroethylene (ePTFE), while the muscular VSDs were left open. We planned percutaneous pulmonary debanding at the age of 5 months, as the muscular VSDs had become small. After dilation with a Mustang® (Boston Scientific, Marlborough, Massachusetts, United State) balloon (12 mm diameter) there was a persistent waist indicating a residual narrowing. Use of an extra-high pressure balloon, Conquest® (Medicon, Osaka, Japan) balloon of the same size, completely eliminated the waist. In in vitro experiments, the Mustang® partially tore the ePTFE, while a Conquest® of the same diameter completely opened the band. The mechanism of debanding was tearing of the ePTFE by the knot of the suture thread. Percutaneous pulmonary debanding to avoid unnecessary surgery is feasible in such a patient if the VSD becomes small. .

Anti-inflammatory and Antibacterial Effects of Covalently Attached Biomembrane-Mimic Polymer Grafts on Gore-Tex Implants.

Expanded polytetrafluoroethylene (ePTFE), also known as Gore-Tex, is widely used as an implantable biomaterial in biomedical applications because of its favorable mechanical properties and biochemical inertness. However, infection and inflammation are two major complications with ePTFE implantations, because pathogenic bacteria can inhabit the microsized pores, without clearance by host immune cells, and the limited biocompatibility can induce foreign body reactions. To minimize these complications, we covalently grafted a biomembrane-mimic polymer, poly(2-methacryloyloxylethyl phosphorylcholine) (PMPC), by partial defluorination followed by UV-induced polymerization with cross-linkers on the ePTFE surface. PMPC grafting greatly reduced serum protein adsorption as well as fibroblast adhesion on the ePTFE surface. Moreover, the PMPC-grafted ePTFE surface exhibited a dramatic inhibition of the adhesion and growth of Staphylococcus aureus, a typical pathogenic bacterium in ePTFE implants, in the porous network. On the basis of an analysis of immune cells and inflammation-related factors, i.e., transforming growth factor-ß (TGF-ß) and myeloperoxidase (MPO), we confirmed that inflammation was efficiently alleviated in tissues around PMPC-grafted ePTFE plates implanted in the backs of rats. Covalent PMPC may be an effective strategy for promoting anti-inflammatory and antibacterial functions in ePTFE implants and to reduce side effects in biomedical applications of ePTFE.

Rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis technique / 器官移植

Objective To explore the feasibility of rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models using magnetic compression anastomosis (MCA) technique. Methods Twelve healthy adult crossbred dogs were evenly divided into the MCA and hand suturing (HS) groups according to the anastomosis method between abdominal aorta and artificial blood vessels. The intraoperative duration of abdominal aorta occlusion, intraoperative condition of anastomotic stoma and postoperative imaging examination of anastomotic stoma were compared between two groups. Results The intraoperative duration of abdominal aorta occlusion in the MCA group was significantly shorter than that in the HS group [(5.2±2.3) min vs. (24.4±4.3) min, P < 0.001]. No anastomotic leakage of blood or anastomotic stenosis occurred in the MCA group during the operation. Intraoperative anastomotic leakage of blood occurred in all of the 6 dogs in the HS group. Among them, 1 dog died of excessive blood loss, and 2 dogs experienced mild anastomotic stenosis due to repeated repair. Postoperative color Doppler ultrasound and angiography showed smooth blood flow at the anastomotic stoma without stenosis or thrombosis in the MCA group. In the HS group, 4 dogs presented with anastomotic stenosis on angiography at postoperative 4 weeks. Conclusions MCA technique may achieve rapid and sutureless anastomosis of artificial vascular replacement of abdominal aorta in dog models, which reduces the incidence of anastomotic complications and accelerates postoperative recovery.

Thermal treatment of expanded polytetraflu-oroethylene (ePTFE) membranes for reconstruction of a valved conduit.

The unique micro porous structure of expanded polytetrafluoroethylene (ePTFE) that allows bio-integration for fixation, as well as overall mechanical integrity make it used successfully in a number of biomedical and clinical applications, which include the reconstruction of the pulmonary valve in in right ventricular outflow tract reconstruction (RVOT) operations. The objective of this study was to determine the effects of the thermal treatment on physical and mechanical properties of ePTFE membranes. ePTFE sheets were cut into 16 rectangle strips (10 mm by 60 mm) and evenly separated into 4 groups. One group was the blank control (group A), while the rest of the three groups (group B to D) were heated to 350°C and cooled to 24°C at different cooling rates (10°C/min, 20°C/min and rapid ambient air cooling) in a temperature controlled atmosphere. The mechanical and morphological characteristics of all the samples were tested using a tensile test machine and a scanning electron microscopy (SEM). The results show that the elastic modulus of group B to D was 24.95%, 33.45% and 72.76% higher than group A. The percentage elongation of groups B to D was found to be between 2.3% and 40.45% lower than group A. The proportion of pores in the ePTFE membrane was reduced following the thermal treatment. There were no morphology differences observed between groups B to D. In summary, the selection of cooling rate was important for preserving the mechanical properties of ePTFE membranes under thermal treatment. These findings may provide useful information for the preparation of molded ePTFE valve in RVOT operations.

Autologous nasal septal cartilage combined with expanded-polytetrafluoroethylene in the secondary nasal deformity correction surgery of postoperative cleft lip / 中华医学美学美容杂志

Objective To correct the nasal deformities of cleft lip by expanded-polytetrafluoroe thylene (e-PTFE) combined with autologous nasal septal cartilage.Methods e-PTFE was placed nearby verge of anterior nasal aperture to raise the fundament of nose.Autologous nasal septal cartilage was harvested and combined with e-PTFE to form a sandwich structure.Nasal tip and collapsed nasaI alar were repaired by this method.Results Fifty cases were treated by this method and 42 cases were followed up for about one year.The results were satisfying.The contour of the nose was similar to normal.Only 3 cases were relapsed after one year.Conclusions e-PTFE combined with autologous nasal septal cartilage is an ideal method to correct nasal deformities of cleft lip.

Guided bone regeneration using two types of non-resorbable barrier membranes

INTRODUCTION: Guided bone regeneration (GBR) is a common procedure for the treatment of bone defects and bone augmentation. The non-resorbable barriers are well-documented barriers for GBR because of their stability and malleability. However, few GBR studies have focused on the different types of non-resorbable barriers. Therefore, this study examined the clinical results of different non-resorbable barriers for GBR; expanded polytetrafluoroethylene (e-PTFE) (TR-Gore Tex, Flagstaff, AZ, USA), and high-density polytetrafluoroethylene (d-PTFE) (Cytoplast membrane, Oraltronics, Bremen, Germany). MATERIALS AND METHODS: The analysis was performed on patients treated with GBR and implant placement from January 2007 to October 2007 in the department of the Seoul National University Bundang Hospital. The patients were divided into two groups based on the type of non-resorbable barrier used, and the amount of bone regeneration, marginal bone resorption after prosthetics, implant survival rate and surgical complication in both groups were evaluated. RESULTS: The implants in both groups showed high survival rates, and the implant-supported prostheses functioned stably during the follow-up period. During the second surgery of the implant, all horizontal defects were filled with new bone, and there was no significant difference in the amount of vertical bone defect. CONCLUSION: In bone defect areas, GBR with non-resorbable barriers can produce favorable results with adequate postoperative management. There was no significant difference in bone regeneration between e-PTFE and d-PTFE.

Polytetrafluoroethylene as a Spacer Graft for the Correction of Lower Eyelid Retraction

PURPOSE: To evaluate the efficacy of porous expanded polytetrafluoroethylene (e-PTFE, Goretex (R) ) containing large pores made with a 21-gauge needle as a graft for the correction of lower lid retraction. METHODS: e-PTFE grafts were implanted between the tarsus and lower lid retractor via a transconjunctival approach with/without amniotic membrane transplantation, or via a transcutaneous approach. Rabbits were examined and assessed for corneal and conjunctival complications and for e-PTFE graft status. Rabbits were sacrificed for a histological study at 8 weeks postoperatively. RESULTS: e-PTFE grafts were uniformly extruded 3 weeks postoperatively in eyelids operated on via the transconjunctival approach. However, rabbits operated on via the transcutaneous approach demonstrated e-PTFE graft retention; in addition, dense fibrovascular ingrowths into the large pores of e-PTFE were observed histologically. CONCLUSIONS: e-PTFE is a good substitute for other graft materials as a spacer in lower lid retraction operations, especially as an interpositional graft using a transcutaneous approach.

Application of China-made expanded polytetrafluoroethylene in plastic and aesthetic surgery / 中国微创外科杂志

Objective To evaluate the clinical efficacy of China-made expanded polytetrafluoroethylene (ePTFE) in the treatment of facial defects and hollow deformities on the face. Methods Facial augmentation was performed in different sites as the forehead, temple, nose, chin, nosal base and maxilla, respectively, to correct the facial defects and hollow deformities, by using either China-made ePTFE (Experimental Group) or imported ePTFE (Control Group). Postoperative parameters between the two groups were compared. Results The Experimental Group included 16 patients (18 sites), in whom the postoperative follow-up was conducted for 6~9 months. In this group, a secondary infection (in the nose) occurred in 1 patient because the implant was placed too superficially and too close proximity to the incision, and the implant was removed out. Delayed healing of the incision (in the chin) with uncovered implant was found in 1 patient, who was cured by the change of dressing. In the rest of the patients, no obvious allergic, inflammatory or rejection reaction was seen and a good cosmetic result was achieved. The satisfactory rate of this group was 94.4%(17/18). The Control Group included 10 patients (20 sites). The implant was found bared and then removed in 1 patient (in the nose). The satisfactory rate of this group was 91.7%(11/12). There were no statistical differences between the two groups in the wound healing ( ? 2 =1 109, P =0 574), the adverse reaction ( P =1 000), and the clinical efficacy ( P =1 000). Conclusions China-made ePTFE gives histocompatibility as good as imported one. It is suitable for filling the soft tissue and can be used as a safe and economical alternative.