title: Primary reconstruction of pelvic floor defects following sacrectomy using Permacol graft.
abstract: OBJECTIVE
  The large pelvic floor defect following sacrectomy for sacral masses leaves the challenging problem of primary closure and herniation. We present the outcome of primary repair using Permacol, a biomaterial made of acellular porcine cross-linked dermal collagen and with similar tensile strength to polypropylene mesh. It is non-allergenic and possibly less likely than synthetic mesh to cause inflammation leading to small bowel adherence; fistula formation and graft extrusion. Following implantation, Permacol is colonized by host cells and resists degradation by host enzymes.
  
  
  METHODS
  Three patients had sacrectomy with primary repair of pelvic floor defects between March 2004 and August 2005. Two had excision of sacral chordomas and one excision of a sacrococcygeal teratoma. Repair of the defect was carried out using the Permacol graft, suturing to the sacrum, anococcygeal raphe and ischial spines. Two suction drains were placed superficial to the mesh.
  
  
  RESULTS
  All patients had gross en-bloc tumour resections and over a median follow-up period of 1year (range 8-25months), there were no complications related to primary repair.
  
  
  CONCLUSIONS
  Primary closure of a large defect following sacrectomy using a Permacol graft, in our early experience seems to be convenient and safe without the development of herniation.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, London, UK. kumar.abhinav@doctors.org.uk
authors.forename: K
authors.initials: K
authors.lastname: Abhinav
authors.forename: M
authors.initials: M
authors.lastname: Shaaban
authors.forename: T
authors.initials: T
authors.lastname: Raymond
authors.forename: T
authors.initials: T
authors.lastname: Oke
authors.forename: R
authors.initials: R
authors.lastname: Gullan
authors.forename: A C V
authors.initials: AC
authors.lastname: Montgomery
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use; D002817:Chordoma / Q000601:surgery; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012445:Sacrococcygeal Region / Q000601:surgery*; D012447:Sacrum / Q000601:surgery*; D013125:Spinal Neoplasms / Q000601:surgery*; D013526:Surgical Mesh; D013724:Teratoma / Q000601:surgery
chemical_list: D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen