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Use of Surgisis for abdominal wall reconstruction in children with abdominal wall defects
Hussein Naji1, Jane Foley1, Henrik Ehren1
1Department of Pediatric Surgery, Astrid Lindgren Children's Hospital, Stockholm, Sweden.
Insights
Porcine small intestine submucosa (Surgisis) effectively repairs pediatric abdominal wall defects with low complication rates. Hernia recurrences resolved spontaneously, indicating its potential as a reliable surgical adjunct.
Area of Science:
- Pediatric Surgery
- Biomaterials in Surgery
- Abdominal Wall Reconstruction
Background:
- Abdominal wall defects in children pose surgical challenges.
- Current reconstruction methods lack a universally established approach.
- Porcine small intestine submucosa (Surgisis) is a potential biomaterial for abdominal closure.
Purpose of the Study:
- To evaluate the efficacy of Surgisis for pediatric abdominal wall defect repair.
- To assess complication rates and recurrence following Surgisis implantation.
- To analyze the long-term outcomes of using this biomaterial.
Main Methods:
- Retrospective review of 24 pediatric patients who underwent abdominal wall reconstruction with Surgisis (2004-2011).
- Analysis of patient demographics, defect etiology, surgical outcomes, and complications.
- Review of recurrence rates and follow-up duration (median 5 years).
Main Results:
- Surgisis implantation led to successful wound healing in all 24 patients.
- Low complication rates observed: 4 seromas and 2 wound infections.
- Two incisional hernia recurrences resolved spontaneously without intervention.
Conclusions:
- Surgisis is an effective adjunct for pediatric abdominal wall defect repair.
- The biomaterial demonstrates a low complication and recurrence profile.
- Spontaneous resolution of recurrences suggests favorable tissue integration and remodeling.
Aim:
Abdominal wall defects in children can present a challenge to the pediatric surgeon. Despite the development of new materials and modifications of surgical technique, no single approach has been established. The purpose of this study was to evaluate the authors experience using porcine small intestine submucosa for abdominal closure.
Patients And Methods:
A retrospective review of all patients with abdominal wall defects who underwent reconstruction with Surgisis at the authors' institution from 2004 to 2011 was performed. Patient demographics, cause of defect, recurrence, rate of infection, and length of follow-up were reviewed.
Results:
A total of 24 patients were identified as having Surgisis implanted for abdominal wall defects. The most common etiology of abdominal defect was omphalocele. All patients went on to heal wounds. Four patients developed postoperative seroma formation and another two had wound infection. Two recurrences in the form of incisional hernia were observed. Both resolved spontaneously without intervention during the follow-up. The median follow-up period was 5 years (range 2-9 y). No significant predictors of complications were identified.
Conclusions:
Surgisis is an effective adjunct in the repair of abdominal wall defects in children. Complication rates remain low. In addition, recurrence may disappear spontaneously as the patch absorbed and replaced by scar tissues. Further studies are warranted.
