Effectiveness and properties of the biological prosthesis Permacol™ in pediatric surgery: A large single center experience

Abstract

IntroductionThe use of prosthetic patches of non-absorbable materials represents a valid tool in the treatment of abdominal wall and diaphragmatic defects in pediatric age. In recent years research has developed biological dermal scaffolds made from a sheet of acellular matrix that can provide the desired support and reduce the occurrence of complications from non-absorbable implant. We present our experience and a systematic review to evaluate the use of biologic prosthesis for abdominal wall closure in pediatric patients.MethodsThe study from January 2009 to January 2015 involved 20 patients treated with Permacol™ implant. We observed postoperative complications only in patients treated for abdominal wall closure, which is the major indication for the use of Permacol™. We conducted a systematic review and meta-analysis (according to PRISMA) on PubMed/Medline, Scopus and EMBASE regarding the use of biological prosthesis in pediatric population considering the incidence of complications as the primary outcome.Results3/20 patients experienced complications: 2 patients with skin necrosis healed conservatively and 1 of them developed laparocele. Thus only 1 patient with incisional hernia had significant surgery complication. In patients who were permanently implanted with Permacol™ it has not determined adverse reactions with optimal functional outcome.ConclusionsIn accordance with the few data (case reports and case series) reported in literature about pediatric patients, our experience in different pathologies and applications has shown the effectiveness of Permacol™, in particular for the non-occurrence of infections, that often affect the use of prosthesis.

Acellular Bovine Pericardial Patch for Difficult Abdominal Closure in the Pediatric Population: Our Experience with Review of Literature

“…The use of both has been reported in patients with gastroschisis, omphalocele, congenital diaphragmatic hernia, incisional hernia, and pediatric transplant recipients with comparable results in terms of infection, seroma formation, and recurrence. [ 16 17 18 19 20 21 22 ] In the series of 24 patients reconstructed with SURGISIS ™ reported by Naji et al ., two developed recurrences, which resolved spontaneously at a 2-year follow-up. [ 20 ]…”

Polydopamine Functionalization: A Smart and Efficient Way to Improve Host Responses to e-PTFE Implants

“…But this crosslinked matrix did not demonstrate significant difference compared to e-PTFE (Mitchell et al, 2008). Recently, Filisetti et al reported their own experience and a literature review on Permacol® in pediatric surgery (Filisetti et al, 2016). One can note that there are no details on the indication of Permacol® in diaphragmatic hernia apart from four records concerning, for two of them, late discoveries of the pathology and, for two others, secondary interventions after Gore-Tex failures.…”