ABSTRACT
Reconstruction of the fascia defect, especially complicated one is challenging problem. We report our experiences of porcine acellular dermal collagen (Permacol(R)) in contaminated fascia defects. Three patients with contaminated fascia defect were reconstructed using Permacol(R). Permacol(R) was fixed to fascia with 2-0 polypropylene sutures and at least 2 cm of the implant was allowed to overlap the defect. Types of fascia defect consisted of large parastomal hernia in rectal cancer patients, multiple enterocutaneous fistulas in Crohn's disease and evisceration due to surgical site infection. Postoperative complication was 1 case of graft infection in a Crohn's disease patient, but infection was controlled using antibiotics.
Subject(s)
Humans , Anti-Bacterial Agents , Collagen , Crohn Disease , Fascia , Hernia , Intestinal Fistula , Polypropylenes , Postoperative Complications , Rectal Neoplasms , Sutures , TransplantsABSTRACT
PURPOSE: Numerous materials, both autologous and nonautologous, have been used for augmentation of sunken areas and each has its own limitations. The ideal material for augmentation should not be absorbed in any manner. This study is designed to assess the survival of SureDerm(R), Permacol(R) graft according to the volume and histologic change. METHODS: Twenty four mice, weighing about 50 grams and of 5 weeks of age were used. SureDerm(R) is an acellular dermal matix obtained from human cadaveric skin. Permacol(R) is a porcine derived acellular dermal matrix whose manufacture involves trypsinisation, solvent extraction. Graft pieces standardized to 1x1cm size were used in each group. The implanted material were taken 1, 4, 8 and 12 weeks later, respectively. The changes of graft volume during the graft period were measured on initial, 1, 4, 8 and 12 weeks. RESULTS: The initial shape of graft was maintained up to 12 weeks in Permacol(R) graft group and mean survival rate was 80.36+/-8.21% in SureDerm(R), 89.57+/-6.39% in Permacol(R)(p=0.01). The volume of each graft decreased 29% from initial volume on 12 weeks in SureDerm(R), 18% in Permacol(R). The structure of Permacol(R) remained until 12 week after implantation. CONCLUSION: Our experimental study suggests that Permacol(R) could be a safe material as an implant for permanent augmentation. However, There are further study remained for antigenicity of these material, and the choice of graft for augmentation should be remained to the clinical situations.