The use of a dura mater patch to cover oesophageal defects of different sizes: an experimental study in chickens.

OBJECTIVE

To find out the optimal size of full thickness oesophageal defects that can be repaired with patches of Tutoplast Dura (solvent dehydrated human dura mater in the form of absorbable collagen).

DESIGN

Experimental study.

SETTING

Teaching hospital, Greece.

MATERIAL: 96 female Hubbard chickens in four groups of 24.

INTERVENTIONS: In the three experimental groups longitudinal defects were made in the cervical oesophagus 30 x 5, 10, or 15 mm and covered with Tutoplast. Subgroups of 6 chickens were weighed, had a barium swallow examination, and were then killed at 2, 4, 6, and 8 weeks. The oesophagus was removed and examined histopathologically.

MAIN OUTCOME MEASURES: Weight, extent of healing macroscopically and microscopically.

RESULTS

All chickens that had had defects 30 x 15 mm in size died between days 5 and 10, and the oesophagus in all cases was obstructed by food. There were no deaths or complications in the other three groups, and no evidence of dysphagia on barium swallow. In chickens with defects of 30 x 5 and 30 x 10 mm the prosthetic material gradually disappeared, and they healed well.

CONCLUSIONS

Defects in the chicken's cervical oesophagus larger than 30 x 10 mm cannot be repaired with a Tutoplast patch, but smaller defects can. Further studies are needed to clarify the mechanisms of healing.