Wotton and Akoh in their previously reported case in this journal postulate that Permacol rejected.This letter provides a detailed critique of that claim and provides an alternative explanation for the histological da...Wotton and Akoh in their previously reported case in this journal postulate that Permacol rejected.This letter provides a detailed critique of that claim and provides an alternative explanation for the histological data provided by the authors.It is also argued that Wotton and Akoh have misrepresented one of the papers in the discussion in their article and a clarification of that referenced paper is given.展开更多
Chest wall reconstruction after rib resection is essential to ensuring chest wall stability, avoiding flail chest and pulmonary hernia, and improving pulmonary function. Traditionally, a synthetic mesh and a musculocu...Chest wall reconstruction after rib resection is essential to ensuring chest wall stability, avoiding flail chest and pulmonary hernia, and improving pulmonary function. Traditionally, a synthetic mesh and a musculocutaneous flap have been used to bridge the chest wall defect. However, a risk of secondary prosthesis infection exists. Acellular dermal collagen mesh implants (Permacol™) are indicated for the reconstruction and reformation of human soft connective tissue. A case of a complex chest wall reconstruction after rib resection for osteomyelitis due to staphylococcus aureus infection in a malnourished, immunosuppressed, and methadone-addicted patient is presented. The patient underwent a left posterolateral thoracotomy and chest wall resection, involving three ribs and the soft tissues overlying an infected cutaneous fistula. The chest wall was reconstructed using a 28 × 18 cm piece of porcine sterile acellular dermal collagen mesh. A successful chest wall repair was achieved with no incisional herniation and with complete mesh incorporation, allowing physiologic respiratory movements. A typical wound seroma developed and resorbed over the following months. There was no infection. In conclusion, this case report suggests that Permacol™surgical implant can be used successfully as an alternative to synthetic mesh in reconstruction of an infected chest wall.展开更多
Permacol mesh has shown promise when used in abdominal wall repair,especially in the presence of a contaminated surgical field.This biomaterial,derived from porcine dermis collagen,has proposed advantages over synth...Permacol mesh has shown promise when used in abdominal wall repair,especially in the presence of a contaminated surgical field.This biomaterial,derived from porcine dermis collagen,has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues.However,we present a case report describing a patient who displayed rejection to a Permacol mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy.Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacoldue to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol.Both animal and human studies show conflicting evidence of biocompatibility.There are several reports of successful use of Permacolto repair complex incisional herniae or abdominal walls in the presence of significant contamination.It appears from the literature that Permacolis a promising material,but as we have demonstrated,it has the potential to evoke a foreign body reaction and rejection in certain subjects.展开更多
文摘Wotton and Akoh in their previously reported case in this journal postulate that Permacol rejected.This letter provides a detailed critique of that claim and provides an alternative explanation for the histological data provided by the authors.It is also argued that Wotton and Akoh have misrepresented one of the papers in the discussion in their article and a clarification of that referenced paper is given.
文摘Chest wall reconstruction after rib resection is essential to ensuring chest wall stability, avoiding flail chest and pulmonary hernia, and improving pulmonary function. Traditionally, a synthetic mesh and a musculocutaneous flap have been used to bridge the chest wall defect. However, a risk of secondary prosthesis infection exists. Acellular dermal collagen mesh implants (Permacol™) are indicated for the reconstruction and reformation of human soft connective tissue. A case of a complex chest wall reconstruction after rib resection for osteomyelitis due to staphylococcus aureus infection in a malnourished, immunosuppressed, and methadone-addicted patient is presented. The patient underwent a left posterolateral thoracotomy and chest wall resection, involving three ribs and the soft tissues overlying an infected cutaneous fistula. The chest wall was reconstructed using a 28 × 18 cm piece of porcine sterile acellular dermal collagen mesh. A successful chest wall repair was achieved with no incisional herniation and with complete mesh incorporation, allowing physiologic respiratory movements. A typical wound seroma developed and resorbed over the following months. There was no infection. In conclusion, this case report suggests that Permacol™surgical implant can be used successfully as an alternative to synthetic mesh in reconstruction of an infected chest wall.
文摘Permacol mesh has shown promise when used in abdominal wall repair,especially in the presence of a contaminated surgical field.This biomaterial,derived from porcine dermis collagen,has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues.However,we present a case report describing a patient who displayed rejection to a Permacol mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy.Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacoldue to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol.Both animal and human studies show conflicting evidence of biocompatibility.There are several reports of successful use of Permacolto repair complex incisional herniae or abdominal walls in the presence of significant contamination.It appears from the literature that Permacolis a promising material,but as we have demonstrated,it has the potential to evoke a foreign body reaction and rejection in certain subjects.
