{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:39:07Z","timestamp":1793191147955,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The treatment of duodenal injuries remains one of the most challenging issues in clinical surgery due to their high morbidity and mortality rates. The primary objective of this study was to evaluate the histopathology and other diagnostic outcomes of wound repair following surgical reconstruction of large experimental duodenal defects using synthetic (ePTFE, expanded polytetrafluoroethylene) or organic (JSP, jejunal serosal patch) materials. Materials and Methods: A total of 20 European rabbits were randomly divided into two equal groups (n = 10 each). A grade III defect covering over 50% of the duodenum\u2019s circumference was created in the second part of the duodenum of the rabbits. The anesthesia, duodenal injury, postoperative care, and animal sacrifice protocols were identical for all experimental rabbits. The effectiveness of JSP and ePTFE patch repair techniques was investigated based on clinical, macroscopic, and microscopic assessments at two and four weeks postoperatively. Results: Survival rates were comparable between groups (p &gt; 0.05). Remarkable mucosal regeneration was evident in all experimental animals by two weeks, showing complete coverage of the jejunal serosal and ePTFE patches by re-epithelialized mucosa with functional villus formation. While partial development of the underlying muscular and serosal layers was observed in both groups at four weeks, the JSP group achieved a significantly higher median histological score (19 vs. 14; p = 0.003). Conversely, the ePTFE group exhibited a major safety concern: a highly significant increase (p \u2264 0.001) in Grade 4 dense, inseparable adhesions throughout the abdominal cavity, which were entirely absent in the JSP group. Conclusions: Both JSP and ePTFE are viable for duodenal reconstruction, but the autologous JSP is superior in tissue healing and safety. Severe adhesions associated with ePTFE constitute a significant clinical concern, limiting its use to a second-line alternative. Consequently, JSP is the preferred option, while ePTFE requires further long-term safety validation.<\/jats:p>","DOI":"10.3390\/medicina62010171","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T08:26:36Z","timestamp":1768465596000},"page":"171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pathological and Diagnostic Assessment of Duodenal Wound Healing: A Comparative Experimental Study of Jejunal Serosal vs. ePTFE Patch Repair"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0316-7047","authenticated-orcid":false,"given":"Ilija","family":"Golubovic","sequence":"first","affiliation":[{"name":"Clinic for Digestive Surgery, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3514-4448","authenticated-orcid":false,"given":"Milan","family":"Radojkovic","sequence":"additional","affiliation":[{"name":"Clinic for Digestive Surgery, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-6681","authenticated-orcid":false,"given":"Ivan","family":"Ilic","sequence":"additional","affiliation":[{"name":"Center for Pathology and Pathological Anatomy, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8618-694X","authenticated-orcid":false,"given":"Vladimir","family":"Petrovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute for Embryology and Histology, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0441-7335","authenticated-orcid":false,"given":"Marko","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"Clinic for Gastroenterology and Hepatology, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0230-6735","authenticated-orcid":false,"given":"Jelena","family":"Zivadinovic","sequence":"additional","affiliation":[{"name":"Clinic for Anesthesiology and Intensive Therapy, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5830-0450","authenticated-orcid":false,"given":"Aleksandar","family":"Vukadinovic","sequence":"additional","affiliation":[{"name":"Clinic for Digestive Surgery, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2955-9070","authenticated-orcid":false,"given":"Nebojsa","family":"Ignjatovic","sequence":"additional","affiliation":[{"name":"Clinic for Digestive Surgery, University Clinical Center Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1080\/00365521.2019.1647456","article-title":"Diagnosis and Management of Duodenal Perforations: A Narrative Review","volume":"54","author":"Ansari","year":"2019","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1177\/00031348211065091","article-title":"Review of Traumatic Duodenal Injuries: Etiology, Diagnosis, and Management","volume":"89","author":"Diggs","year":"2023","journal-title":"Am. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1097\/TA.0000000000002299","article-title":"Management of Duodenal Trauma","volume":"87","year":"2019","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_4","first-page":"44","article-title":"Postcholecystectomy Duodenal Injuries, Their Management, and Review of the Literature","volume":"14","year":"2024","journal-title":"Euroasian J. Hepatogastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.amjsurg.2022.12.016","article-title":"Management of the Complex Duodenal Injury","volume":"225","author":"Bolaji","year":"2023","journal-title":"Am. J. Surg."},{"key":"ref_6","first-page":"e40431","article-title":"Management of Complex Duodenal Injuries After Penetrating Trauma","volume":"15","author":"McCague","year":"2023","journal-title":"Cureus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0002-9610(01)00586-4","article-title":"Comparison of Different Surgical Repairs in the Treatment of Experimental Duodenal Injuries","volume":"181","author":"Karademir","year":"2001","journal-title":"Am. J. Surg."},{"key":"ref_8","first-page":"907","article-title":"Assessing Two Methods of Repair of Duodenal Defects, Jejunal Serosal Patch and Jejunal Pedicled Flap (An Experimental Animal Study)","volume":"64","author":"Ziaian","year":"2014","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s00595-009-3948-2","article-title":"The Repair of a Large Duodenal Defect by a Pedicled Gastric Seromuscular Flap","volume":"39","author":"Aslan","year":"2009","journal-title":"Surg. Today"},{"key":"ref_10","first-page":"107","article-title":"Reinforcement of the Suture Line With an ePTFE Graft Attached with Histoacryl Glue in Duodenal Trauma","volume":"49","author":"Saygun","year":"2006","journal-title":"Can. J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jss.2007.03.031","article-title":"Repairing Large Duodenal Injuries in Dogs by Expanded Polytetrafluoroethylene Patch","volume":"144","author":"Nikeghbalian","year":"2008","journal-title":"J. Surg. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1308\/rcsann.2023.0074","article-title":"Use of Jejunal Serosal Patch and Pyloric Exclusion in the Management of Complex Duodenal Injury","volume":"106","author":"Alsaadi","year":"2024","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_13","first-page":"9","article-title":"Use of A Polytetrafluoroethylene Tube and Patch in the Repair of a Difficult Duodenal Stump","volume":"33","author":"Roura","year":"2003","journal-title":"Acta Gastroenterol. Latinoam."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/00000658-200205000-00013","article-title":"Repair of Full-Thickness Defects in Alimentary Tract Wall With Patches of Expanded Polytetrafluoroethylene","volume":"235","author":"Oh","year":"2002","journal-title":"Ann. Surg."},{"key":"ref_15","unstructured":"National Research Council (US) Committee for the Update of the Guide for the Care and Use of Laboratory Animals (2011). Guide for the Care and Use of Laboratory Animals, National Academies Press. [8th ed.]."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1016\/j.jss.2024.07.119","article-title":"Management of Traumatic Duodenal Injury: Is There a Role for Early Parenteral Nutrition?","volume":"302","author":"Vira","year":"2024","journal-title":"J. Surg. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jss.2022.06.063","article-title":"Repair by Primary Closure of Traumatic Blunt Duodenal Injuries: Simple is Not Always Safe","volume":"280","author":"Bagaria","year":"2022","journal-title":"J. Surg. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1002\/vms3.1157","article-title":"Debridement and Primary Closure of a Mesenteric Duodenal Perforation in a Dog","volume":"9","author":"Edwards","year":"2023","journal-title":"Vet. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111721","DOI":"10.1016\/j.injury.2024.111721","article-title":"Pancreaticoduodenectomy in High-Grade Pancreatic and Duodenal Trauma","volume":"55","author":"Noorbakhsh","year":"2024","journal-title":"Injury"},{"key":"ref_20","first-page":"e39995","article-title":"Triple Tube Drainage for the Treatment of Complex Duodenal Injury: A Case Report and Literature Update","volume":"15","author":"Karveli","year":"2023","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1097\/TA.0000000000002157","article-title":"Management of Duodenal Trauma: A Retrospective Review from the Panamerican Trauma Society","volume":"86","author":"Ferrada","year":"2019","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_22","first-page":"340","article-title":"A Simple Method for the Management of Experimental Wounds of The Duodenum","volume":"116","author":"Kobold","year":"1963","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"63","DOI":"10.4314\/ecajs.v21i3.11","article-title":"The Jejunal Serosal Patch Procedure: A Successful Technique for Managing Difficult Peptic Ulcer Perforation","volume":"21","author":"Bekele","year":"2016","journal-title":"East Centr. Afr. J. Surg."},{"key":"ref_24","unstructured":"Seeras, K., Acho, R.J., and Lopez, P.P. (2023). Roux-En-Y Gastric Bypass Chronic Complications. StatPearls, StatPearls Publishing."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19161","DOI":"10.1021\/acsami.7b02696","article-title":"Anti-Inflammatory and Antibacterial Effects of Covalently Attached Biomembrane-Mimic Polymer Grafts on Gore-Tex Implants","volume":"9","author":"Jin","year":"2017","journal-title":"ACS Appl. Mater. Interfaces"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1016\/j.transproceed.2023.03.082","article-title":"Complications of e-PTFE Grafts in LDLT: Evaluation of Case Series","volume":"55","author":"Polat","year":"2023","journal-title":"Transplant Proc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.jss.2018.11.051","article-title":"Autologous Vascularization: A Method to Enhance the Antibacterial Adhesion Properties of ePTFE","volume":"236","author":"Lei","year":"2019","journal-title":"J. Surg. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100412","DOI":"10.1016\/j.mtchem.2020.100412","article-title":"ePTFE Functionalization for Medical Applications","volume":"20","author":"Roina","year":"2021","journal-title":"Mater. Today Chem."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3897\/folmed.64.e60553","article-title":"Immunological Response To Nonresorbable Barrier Membranes Used for Guided Bone Regeneration and Formation of Pseudo Periosteum: A Narrative Review","volume":"64","author":"Giragosyan","year":"2022","journal-title":"Folia Med."},{"key":"ref_30","first-page":"101829","article-title":"Middle To Long-Term Outcomes and Pathological Changes of Implanted Expanded Polytetrafluoroethylene Valved Conduits","volume":"61","author":"Cai","year":"2025","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1002\/(SICI)1097-4636(199905)45:2<84::AID-JBM2>3.0.CO;2-O","article-title":"Comparative Experimental Study of Esophageal Wall Regeneration After Prosthetic Replacement","volume":"45","author":"Freud","year":"1999","journal-title":"J. Biomed. Mater. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1002\/jbm.b.34928","article-title":"ePTFE-Based Biomedical Devices: An Overview of Surgical Efficiency","volume":"110","author":"Roina","year":"2022","journal-title":"J. Biomed. Mater. Res. B Appl. Biomater."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"212828","DOI":"10.1016\/j.bioadv.2022.212828","article-title":"Biomaterial and Biocompatibility Evaluation of Tunicate Nanocellulose for Tissue Engineering","volume":"137","author":"Apelgren","year":"2022","journal-title":"Biomater. Adv."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/171\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T10:26:00Z","timestamp":1768472760000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/1\/171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["medicina62010171"],"URL":"https:\/\/doi.org\/10.3390\/medicina62010171","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]}}}