title: [Use of Permacol in complicated incisional hernia].
abstract: Polypropylene mesh repair is the gold standard for primary inguinal hernia and incisional hernia. Wound infection and small bowel fistulas are contraindications to polypropylene mesh repair. In addition, synthetic meshes are known to cause severe peritoneal adhesions and enteric fistulas if located close to the bowel. Porcine intestinal submucosa has been used successfully in experimental studies in dogs and rats to repair large abdominal wall defects. A new porcine dermal collagen graft has been used in man for groin hernia repair, incisional hernia repair and other surgical procedures without complications. We describe 6 cases of complicated incisional hernia operated in emergency using porcine dermal collagen grafts. In one woman the incisional hernia was associated with an enterovaginal fistula. Three cases presented severe wound infections, two of which related to a previous polypropylene mesh repair, while another had an irreducible recurrent incisional hernia and one woman presented complete evisceration. None of the patients had postoperative or porcine-graft-related complications. Over a follow-up period of 3-24 months we have had no recurrence or wound infection. The results of these few cases confirm the safety and efficacy of the porcine dermal collagen mesh also in incisional hernia repair.
authors.affiliation: Dipartimento di Emergenza, UOSC Osservazione Chirurgica e Polispecialistica Azienda Ospedaliera di Rilievo Nazionale A Cardarelli, Napoli.
authors.forename: Mariano Fortunato
authors.initials: MF
authors.lastname: Armellino
authors.forename: Guglielmo
authors.initials: G
authors.lastname: De Stefano
authors.forename: Francesco
authors.initials: F
authors.lastname: Scardi
authors.forename: Anna Lucia
authors.initials: AL
authors.lastname: Forner
authors.forename: Francesco
authors.initials: F
authors.lastname: Ambrosino
authors.forename: Roberto
authors.initials: R
authors.lastname: Bellotti
authors.forename: Umberto
authors.initials: U
authors.lastname: Robustelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Stefano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen