Posterior repair with perforated porcine dermal graft.
OBJECTIVE
To compare postoperative vaginal incision separation and healing in patients undergoing posterior repair with perforated porcine dermal grafts with those that received grafts without perforations. Secondarily, the tensile properties of the perforated and non-perforated grafts were measured and compared.


METHODS
This was a non-randomized retrospective cohort analysis of women with stage II or greater rectoceles who underwent posterior repair with perforated and non-perforated porcine dermal grafts (Pelvicol(TM) CR Bard Covington, GA USA). The incidence of postoperative vaginal incision separation (dehiscence) was compared. A secondary analysis to assess graft tensile strength, suture pull out strength, and flexibility after perforation was performed using standard test method TM 0133 and ASTM bending and resistance protocols.


RESULTS
Seventeen percent of patients (21/127) who received grafts without perforations developed vaginal incision dehiscence compared to 7% (5/71) of patients who received perforated grafts (p = 0.078). Four patients with vaginal incision dehiscence with non-perforated grafts required surgical revision to facilitate healing. Neither tensile strength or suture pull out strength were significantly different between perforated and non-perforated grafts (p = 0.81, p = 0.29, respectively). There was no difference in the flexibility of the two grafts (p = 0.20).


CONCLUSIONS
Perforated porcine dermal grafts retain their tensile properties and are associated with fewer vaginal incision dehiscences.
Taylor
G Bernard
GB
Department of Obstetrics and Gynecology (GBT), Carolinas Medical Center, Charlotte, North Carolina 28232-2861, USA. Bernard.taylor@carolinashealthcare.org
Moore
Robert D
RD
Miklos
John R
JR
Mattox
T Fleming
TF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D020047:Rectocele / Q000601:surgery*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013552:Swine; D014183:Transplantation, Heterologous; D016896:Treatment Outcome