Chest wall reconstruction using implantable cross-linked porcine dermal collagen matrix (Permacol)

Area of Science:

• Pediatric surgery
• Biomaterials science
• Thoracic oncology

Background:

• Traditional chest wall reconstruction methods in children include primary tissue repair and synthetic mesh prostheses.
• Primary tissue repair is linked to high rates of scoliosis.
• Synthetic prostheses involve permanent foreign bodies in growing children.

Purpose of the Study:

• To evaluate the safety and efficacy of biologic mesh (Permacol) for pediatric chest wall reconstruction.
• To present an alternative to conventional reconstruction techniques.
• To assess complications and spinal angulation in pediatric patients.

Main Methods:

• Retrospective chart review of patients undergoing chest wall reconstruction with biologic mesh (2007-2011).
• Data collected: demographics, resection indication, ribs resected, radiation, follow-up duration, complications, and spinal angulation.
• Analysis of pre-operative and post-operative spinal alignment.

Main Results:

• Five pediatric patients (mean age 15.4 years) underwent reconstruction for primary chest wall malignancy.
• No mesh-related postoperative complications were observed.
• No patients developed clinically significant scoliosis during a mean follow-up of 1.9 years.

Conclusions:

• Biologic mesh is a safe and reliable option for pediatric chest wall reconstruction.
• It serves as an effective alternative to primary tissue repair and synthetic mesh.
• This approach mitigates risks associated with traditional methods in growing children.