Chest wall reconstruction using implantable cross-linked porcine dermal collagen matrix (Permacol).
OBJECTIVE
Chest wall reconstruction in children is typically accomplished with either primary tissue repair or synthetic mesh prostheses. Primary tissue repair has been associated with high rates of scoliosis, whereas synthetic prostheses necessitate the placement of a permanent foreign body in growing children. This report describes the use of biologic mesh (Permacol; Covidien, Mansfield, MA) as an alternative to both tissue repair and synthetic prostheses in pediatric chest wall reconstruction.


METHODS
A retrospective chart review was performed identifying patients undergoing chest wall reconstruction with biologic mesh at our tertiary referral children's hospital between 2007 and 2011. Data collection included patient demographics, indication for chest wall resection, number of ribs resected, the administration of postoperative radiation, length of follow-up, postoperative complications, and the degree of spinal angulation (preoperatively and at most recent follow-up).


RESULTS
Five patients (age, 9.0-21.7 years; mean, 15.4 years) underwent resection for primary chest wall malignancy followed by reconstruction with biologic mesh (Permacol) during the study period. There were no postoperative mesh-related complications, and none of the patients developed clinically significant scoliosis (follow-up, 1.1-2.6 years; mean 1.9 years).


CONCLUSIONS
Biologic mesh offers a safe and dependable alternative to both primary tissue repair and synthetic mesh in pediatric patients undergoing chest wall reconstruction.
Lucile Packard Children's Hospital, Stanford University, Palo Alto, CA 94305, USA.
Shawn R
SR
Lin
Zachary J
ZJ
Kastenberg
Matias
M
Bruzoni
Craig T
CT
Albanese
Sanjeev
S
Dutta
D000293:Adolescent; D001672:Biocompatible Materials; D001859:Bone Neoplasms / Q000601:surgery; D002648:Child; D003094:Collagen; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012086:Reoperation; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000601:surgery; D013584:Sarcoma, Synovial / Q000601:surgery; D012600:Scoliosis / Q000209:etiology / Q000517:prevention & control; D013526:Surgical Mesh; D013899:Thoracic Neoplasms / Q000601:surgery*; D035441:Thoracic Wall / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen