Use of a porcine dermal collagen implant for contaminated abdominal wall reconstruction in a 105-year-old woman: a case report and review of the literature

Idit Melnik, Dimitry Goldstein, Boris Yoffe, Idit Melnik, Dimitry Goldstein, Boris Yoffe

Abstract

Introduction: Repair of contaminated abdominal wall defect in a geriatric patient is a challenge for the surgeon. We present the case of the oldest patient (105-years old) to successfully undergo a single-stage repair of a contaminated abdominal wall defect with a Permacol™ implant.

Case presentation: A 105-year-old Caucasian woman presented to our emergency room with a clinical and radiological diagnosis of small bowel obstruction due to prior operative adhesions. She underwent laparotomy with small bowel resection and primary closure of her abdomen. There was total eventration of her bowel through the suture line 9 days after surgery. She underwent a second laparotomy that revealed no signs of peritonitis or turbid fluid. Her abdomen was closed with a 15 × 10 cm Permacol™ implant sutured sublay with prolene sutures. Her postoperative period was unremarkable. After a follow-up period of 3 years and 2 months, there was no sign of recurrent hernia or wound contamination.

Conclusion: We suggest that Permacol™ mesh can be considered an efficient alternative to primary closure or synthetic mesh in geriatric patients with contaminated abdominal wall defects.

References

    1. Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, IJzermans JN, et al. A comparison of suture repair with mesh repair for incisional hernia. New Engl J Med. 2000;343(6):392–8. doi: 10.1056/NEJM200008103430603.
    1. Helton WS, Fisichella PM, Berger R, Horgan S, Espat NJ, Abcarian H. Short-term outcomes with small intestinal submucosa for ventral abdominal hernia. Arch Surg. 2005;140(6):549–60. doi: 10.1001/archsurg.140.6.549.
    1. Liyanage S, Purohit G, Frye J, Giordano P. Anterior abdominal wall reconstruction with a Permacol implant. J Plast Reconstr Aesthetic Surg. 2006;59(5):553–5. doi: 10.1016/j.bjps.2005.06.008.
    1. Parker DM, Armstrong PJ, Frizzi JD, North JH., Jr Porcine dermal collagen (Permacol) for abdominal wall reconstruction. Curr Surg. 2006;63(4):255–8. doi: 10.1016/j.cursur.2006.05.003.
    1. Fabian TC, Croce MA, Pritchard FE, Minard G, Hickerson WL, Howell RL, et al. Planned ventral hernia. Staged management for acute abdominal wall defects. Ann Surg. 1994;219(6):643–50. doi: 10.1097/00000658-199406000-00007.
    1. Jernigan TW, Fabian TC, Croce MA, Moore N, Pritchard FE, Minard G, et al. Staged management of giant abdominal wall defects: acute and long-term results. Ann Surg. 2003;238(3):349–55.
    1. Loganathan A, Ainslie WG, Wedgwood KR. Initial evaluation of Permacol bioprosthesis for the repair of complex incisional and parastomal hernias. Surgeon. 2010;8(4):202–5. doi: 10.1016/j.surge.2009.11.002.
    1. Catena F, Ansaloni L, Gazzotti F, Gagliardi S, Di Saverio S, D’Alessandro L, et al. Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields. Hernia. 2007;11(1):57–60. doi: 10.1007/s10029-006-0171-6.
    1. Smart NJ, Marshall M, Daniels IR. Biological meshes: a review of their use in abdominal wall hernia repairs. Surgeon. 2012;10(3):159–71. doi: 10.1016/j.surge.2012.02.006.
    1. Zheng F, Lin Y, Verbeken E, Claerhout F, Fastrez M, De Ridder D, et al. Host response after reconstruction of abdominal wall defects with porcine dermal collagen in a rat model. Am J Obstet Gynecol. 2004;191(6):1961–70. doi: 10.1016/j.ajog.2004.01.091.
    1. Macleod TM, Williams G, Sanders R, Green CJ. Histological evaluation of Permacol as a subcutaneous implant over a 20-week period in the rat model. Br J Plast Surg. 2005;58(4):518–32. doi: 10.1016/j.bjps.2004.12.012.
    1. Sarmah BD, Holl-Allen RT. Porcine dermal collagen repair of incisional herniae. Br J Surg. 1984;71(7):524–5. doi: 10.1002/bjs.1800710717.
    1. de Castro Brás LE, Shurey S, Sibbons PD. Evaluation of crosslinked and non-crosslinked biologic prostheses for abdominal hernia repair. Hernia. 2012;16(1):77–89. doi: 10.1007/s10029-011-0859-0.
    1. Mulier KE, Nguyen AH, Delaney JP, Marquez S. Comparison of Permacol™ and Strattice™ for the repair of abdominal wall defects. Hernia. 2011;15(3):315–9. doi: 10.1007/s10029-010-0777-6.
    1. Hsu PW, Salgado CJ, Kent K, Finnegan M, Pello M, Simons R, et al. Evaluation of porcine dermal collagen (Permacol) used in abdominal wall reconstruction. J Plast Reconstr Aesthet Surg. 2009;62(11):1484–9. doi: 10.1016/j.bjps.2008.04.060.
    1. García-Pumarino R, Pascual G, Rodríguez M, Pérez-Köhler B, Manuel Bellón J. Do collagen meshes offer any benefits over preclude® ePTFE implants in contaminated surgical fields? A comparative in vitro and in vivo study. J Biomed Mater Res B Appl Biomater. 2014;102(2):366–75. doi: 10.1002/jbm.b.33015.
    1. Rosen MJ, Krpata DM, Ermlich B, Blatnik JA. A 5-year clinical experience with single-staged repairs of infected and contaminated abdominal wall defects utilizing biologic mesh. Ann Surg. 2013;257(6):991–6. doi: 10.1097/SLA.0b013e3182849871.
    1. Carbonell AM, Criss CN, Cobb WS, Novitsky YW, Rosen MJ. Outcomes of synthetic mesh in contaminated ventral hernia repairs. J Am Coll Surg. 2013;217(6):991–8. doi: 10.1016/j.jamcollsurg.2013.07.382.
    1. Munegato G, Brandolese R. Respiratory physiopathology in surgical repair for large incisional hernias of the abdominal wall. J Am Coll Surg. 2001;192(3):298–304. doi: 10.1016/S1072-7515(01)00776-1.

Source: PubMed

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