The use of a reinforced tissue matrix (OviTex) in paediatric reconstructive surgery

Abdominal and thoracic reconstructive surgery has always been an aspect of paediatric surgery for conditions such as congenital abdominal wall defects and incisional herniae. Reinforced tissue matrices are ideal for the paediatric population as consideration needs to be given to future growth and potential reoperation. We present our experience with an ovine reinforced tissue matrix (ORTM), OviTex®, (TELA Bio, Malvern, PA, USA).

All patients who underwent abdominal or thoracic reconstruction at our institutions using ORTM 2019-2024 were reviewed. A cohort analysis was done with patients undergoing abdominal wall reconstruction prior to the use of ORTM, 2010-2019.

The ORTM was used in 35 children, (21 male). Median age at insertion 4.3 years (2.1-6.9), weight 15.5 kg (9.4-28.3). The most common diagnoses were exomphalos major (n = 15), emergency laparotomy (n = 9), diaphragmatic hernia (n = 5). In the ORTM group there were no abdominal or thoracic wall hernia recurrences. There was one surgical site infection (SSI) unrelated to the ORTM. There was a surgical site occurrence (SSO) in 3 % (n = 1 skin dehiscence). Median follow up 8.5 months (3.7-14.3). Prior to the use of ORTM, alternative closure techniques were used in 11 children with exomphalos major (7 male). Compared to the ORTM group they had 55 % (n = 6) vs 0 % (n = 0) recurrences (p = 0.002), 9 % (n = 1) vs 0 % (n = 0) SSI (p = 0.42) and 36 % (n = 4) vs 0 % (n = 0) SSO (p = 0.02).

Our series demonstrates that ORTM can be used safely in paediatric reconstructive surgery with excellent outcomes superior to other synthetic and biologic materials with a low rate of SSI/SSO.