title: A retrospective study evaluating the use of Permacol™ surgical implant in incisional and ventral hernia repair.
abstract: BACKGROUND
  The outcome of incisional and ventral hernia repair depends on surgical technique, patient, and material. Permacol™ surgical implant (crosslinked porcine collagen) has been used for over a decade; however, there are few data on outcomes. This study is the largest retrospective multinational study to date to evaluate outcomes with Permacol™ surgical implant in the repair of incisional and ventral hernias.
  
  
  METHODS
  Data were collected retrospectively on 343 patients treated for 213 incisional and 130 ventral hernias. Data evaluated included patient demographics, wound classification, surgical technique, morbidity, and recurrence rates.
  
  
  RESULTS
  Median follow-up time was 649 days (max: 2857), median age 57 years (range 23-91), and BMI 32 kg/m(2) (range 17.6-77.8). Two or more comorbidities were present in 70% of patients. Open surgery was performed in 220 (64%) patients. Permacol™ surgical implant was used as an underlay (250), sublay (39), onlay (37), or inlay (17). Surgical techniques included component separation (89; 25.9%), modified Stoppa technique (197; 57.4%), and Rives-Stoppa (17; 5.0%). CDC Surgical Wound Classification was Class I (190), Class II (103), Class III (28), and Class IV (22). Complications were seen in 40.5% (139) of the patients, with seroma (19%) and wound infection (15%) as the most common. Mesh removal occurred in 1 (0.3%) patient. Kaplan-Meier analysis demonstrated that the probabilities for hernia recurrence at one, two, and three years were 5.8%, 16.6%, and 31.0%, respectively.
  
  
  CONCLUSIONS
  Permacol™ surgical implant was shown to be safe with relatively low rates of hernia recurrence.
  
  
  BACKGROUND
  NCT01214252 (http://www.clinicaltrials.gov).
authors: Loyola University, 2160 South First Ave., Maywood, IL 60153, USA. Electronic address: bchand@lumc.edu.
authors: Bipan
authors: B
authors: Chand
authors: Penn State Milton S. Hershey Medical Center, 500 University Drive, UPC I, Suite 3100, Hershey, PA 17033, USA.
authors: Matthew
authors: M
authors: Indeck
authors: Ohio State University Medical Center, 410 W. 10th Ave., Columbus, OH, USA.
authors: Bradley
authors: B
authors: Needleman
authors: Our Lady of Lourdes Hospital, 120 White Horse Pike, Suite 103, Haddon Heights, NJ 08035, USA.
authors: Matthew
authors: M
authors: Finnegan
authors: University of Texas Health and Science Center, 7703 Floyd Curl Dr., San Antonio, TX 78229, USA.
authors: Kent R
authors: KR
authors: Van Sickle
authors: St. Olavs Hospital, Olav Kyrres Gt 17, N-7006 Trondheim, Norway.
authors: Brynjulf
authors: B
authors: Ystgaard
authors: University Hospital, Policlinico Umberto I, Rome 00162, Italy.
authors: Francesco
authors: F
authors: Gossetti
authors: Torbay Hospital, Hutchings Ward, Lawes Bridge, Torquay TQ2 7AA, UK.
authors: Rupert D
authors: RD
authors: Pullan
authors: Whipps Cross University Hospital, Barts Health NHS Trust, Whipps Cross Rd., Leytonstone, London E11 1NR, UK.
authors: Pasquale
authors: P
authors: Giordano
authors: Aberdeen Royal Infirmary, Foresterhill AB25 2ZN, UK.
authors: Aileen
authors: A
authors: McKinley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001672:Biocompatible Materials; D003094:Collagen; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D013552:Swine; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen
keywords: Abdominal wall; Biocompatible materials; Collagen; Hernia; Recurrence; Retrospective studies; Surgical mesh