Disadvantages

Fabric Construction

There are 3 types of commercial prostheses used in manufacturing synthetic graft: woven, knitted and velour.

Woven Fabrics

1. Poor compliance due to inability to undergo alteration as being too rigid and tightly woven.

2. Poor healing response.

3. Low permeability.

Knitted Fabrics

1. Cannot be too thin as they cannot support cyclic stresses of the arterial circulation over a long period.

2. High porosity of knitted Dacron graft experiences difficulty to undergo preclotting before implantation. (Preclotting crucial in reducing bleeding).

Now, let's move on to synthetic graft:

Synthetic Grafts

1. Higher probability to suffer coagulation if compare to biological grafts

2. Blockage occurs, disastrous to patients.

The 3 main types of synthetic graft - Polytetrafluoroethylene(PTFE) also known as Teflon, Dacron, Nylon:

Teflon

1. Poor patency rates.

2. Require multiple throws to ensure safe knots.

Dacron

1. Poor patency rates.

2. Unsuitable for small-vessel reconstruction, such as the below-knee popliteal or tibial.

Here, we will be discussing about biological graft:

Biological Vascular Grafts - Autograft, Allograft, Xenograft

Autograft

1. Damage may occur during removal and reimplantation.

2. Methods of preparation and preservation are different and more complicated.

3. Degradation and shrinkage of endothelial cells due to mechanical forces not experienced during grafting.

4. Patient need to undergo longer surgery because it involves harvest and implantation of same patient.

5. Weakening of patient's certain extensor and flexor apparatus(harvested site).

Allograft

1. Disease transmission such as HIV and hepatitis.

2. Higher probability of rejection compare to autograft.

3. Damage may occur during removal and implantation.

4. Methods of preparation and preservation are different and more complicated.

Xenograft

1. Damage may occur during removal and implantation.

2. Methods of preparation and preservation are different and more complicated.

3. Animals have shorter life span - transplanted animal graft will age faster.

4. Animals that are closely related to human like chimpanzees are endangered species.

5. Immuno-response may occur due to rejection.