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. 2016 Mar 11:7:48-54.
doi: 10.1016/j.amsu.2016.03.017. eCollection 2016 May.

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

Claudia Filisetti  1 , Sara Costanzo  2 , Federica Marinoni  2 , Claudio Vella  2 , Catherine Klercy  3 , Giovanna Riccipetitoni  2
Affiliations

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

Claudia Filisetti et al. Ann Med Surg (Lond). .

Abstract

Introduction: The 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.

Methods: The 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.

Results: 3/20 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.

Conclusions: In 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.

Keywords: Abdominal wall; Biological prosthesis; Pediatric patients; Permacol.

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Figures

Fig. 1
Fig. 1
Use of Permacol™ in the closure of a gastroschisis associated with colonic aganglionosis. A. At birth positioning of silo. B-C) Abdomen closure using Permacol™. D) XI postoperative day.
Fig. 2
Fig. 2
Right diaphragmatic hernia repair. A) Intraoperative isolation of diaphragmatic defect. B) Closure of the diaphragmatic defect using Permacol™. C-D) Preoperative and postoperative imaging.
Fig. 3
Fig. 3
Search strategy and study selection PRISMA flowchart for the meta-analysis.
Fig. 4
Fig. 4
Meta-analytic estimate of the overall incidence of any complication. Forest plot with the rate of events in each considered study as well as the pooled estimate.
See this image and copyright information in PMC

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