J Korean Surg Soc.  2009 Sep;77(3):216-220. 10.4174/jkss.2009.77.3.216.

Experience with Porcine Acellular Dermal Collagen (Permacol(R)) Implant in Contaminated Fascia Defects

• Choi SI
• Lee KY
• Park SJ
• Lee SH

• KMID: 2004223
• DOI: http://doi.org/10.4174/jkss.2009.77.3.216

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.

Keyword

Permacol(R); Fascia defect; Reconstruction

MeSH Terms

Anti-Bacterial Agents
Collagen
Crohn Disease
Fascia
Hernia
Humans
Intestinal Fistula
Polypropylenes
Postoperative Complications
Rectal Neoplasms
Sutures
Transplants
Anti-Bacterial Agents
Collagen
Polypropylenes

Figure

• 

  Fig. 1 Reconstruction of parastomal hernia using Permacol®-"Top Hat" method. (A) The "Top hat" using Permacol®. (B) Parastomal hernia is seen before reconstruction. (C) Parastomal protrusion corrected after reconstruction.

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  Fig. 2 Using Permacol® for reconstruction of contaminated abdominal wall defect with multiple enterocutaneous fistula in Crohn's disease. (A) Multiple enterocutaneous fistulas around ileostomy is seen. (B) Ileostomy is taken down and debridement is done on fistulous tracts. (C) Ileostomy is relocated in RLQ and previous ileostomy site is reconstructed with Permacol®.

• 

  Fig. 3 Reconstruction of Wound Evisceration due to wound infection using Permacol®. (A) Evisceration is caused by wound infection. (B) Abdominal wall defect with infection is reconstructed using Permacol®.

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