Chest wall reconstruction using implantable cross-linked porcine dermal collagen matrix (Permacol)

J Pediatr Surg. 2012 Jul;47(7):1472-5. doi: 10.1016/j.jpedsurg.2012.05.002.

Abstract

Background/purpose: Chest wall reconstruction in children is typically accomplished with either primary tissue repair or synthetic mesh prostheses. Primary tissue repair has been associated with high rates of scoliosis, whereas synthetic prostheses necessitate the placement of a permanent foreign body in growing children. This report describes the use of biologic mesh (Permacol; Covidien, Mansfield, MA) as an alternative to both tissue repair and synthetic prostheses in pediatric chest wall reconstruction.

Methods: A retrospective chart review was performed identifying patients undergoing chest wall reconstruction with biologic mesh at our tertiary referral children's hospital between 2007 and 2011. Data collection included patient demographics, indication for chest wall resection, number of ribs resected, the administration of postoperative radiation, length of follow-up, postoperative complications, and the degree of spinal angulation (preoperatively and at most recent follow-up).

Results: Five patients (age, 9.0-21.7 years; mean, 15.4 years) underwent resection for primary chest wall malignancy followed by reconstruction with biologic mesh (Permacol) during the study period. There were no postoperative mesh-related complications, and none of the patients developed clinically significant scoliosis (follow-up, 1.1-2.6 years; mean 1.9 years).

Conclusion: Biologic mesh offers a safe and dependable alternative to both primary tissue repair and synthetic mesh in pediatric patients undergoing chest wall reconstruction.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Biocompatible Materials*
  • Bone Neoplasms / surgery
  • Child
  • Collagen*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Neuroectodermal Tumors, Primitive, Peripheral / surgery
  • Plastic Surgery Procedures / instrumentation*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / prevention & control
  • Reoperation
  • Retrospective Studies
  • Sarcoma, Ewing / surgery
  • Sarcoma, Synovial / surgery
  • Scoliosis / etiology
  • Scoliosis / prevention & control
  • Surgical Mesh*
  • Thoracic Neoplasms / surgery*
  • Thoracic Wall / pathology
  • Thoracic Wall / surgery*
  • Treatment Outcome
  • Young Adult

Substances

  • Biocompatible Materials
  • Permacol
  • Collagen