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The use of an acellular porcine dermal collagen implant in the repair of complex abdominal wall defects: a European multicentre retrospective study

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Abstract

Background

The use of biological materials for the repair of complex abdominal wall defects has increased over the years; however, the role of these materials in routine practice remains unclear. The aim of the study was to evaluate clinical outcomes following the use of Permacol™ porcine collagen surgical implant in complex abdominal wall repair.

Methods

This subset analysis of seven European sites from a multicentre retrospective study included patients undergoing open or laparoscopic surgery and treated with Permacol™ surgical implant. Inguinal, parastomal, diaphragmatic, perineal, and hiatal repairs were excluded. Only patients with at least 12 months of follow-up after surgery were included.

Results

A total of 109 patients (56 males and 53 females) were included. Patients had a median of two comorbidities (range 0–6). Thirty-three per cent of patients were treated for recurrent hernia. All but one case used an open approach. Sixty-six per cent were Center for Disease Control wound class II–IV at the time of surgery. Fascial closure was achieved in 69%. Median follow-up length was 720 days (range 368–2857). Recurrence rates at 1 and 2 years were 9.2 and 18.3 %, respectively, and were higher in cases without fascial closure. One-year recurrence was higher following use of an onlay technique (P = 0.025). In a multivariate analysis, among 16 comorbidities examined only fascial closure significantly impacted 1-year recurrence (P = 0.049).

Conclusions

Data from this large retrospective multicentre European study strongly suggest the use of Permacol™ porcine collagen surgical implant to be safe and effective for complex abdominal wall repair. The recurrence rate was impacted by fascial closure.

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Acknowledgments

Editorial support (Kristin L. Hood, PhD and Brittany Eno), biostatistical analysis (Sylvain Anselme), and manuscript review (Patrice Becker, Scott Chouinard, PhD) were provided by Covidien. This study was sponsored and funded by Covidien. All authors and their institutions received funding to complete this study. Pasquale Giordano is a speaker and trainer for Covidien. Authors had complete access to study data. This paper was drafted by PG and reviewed critically by all authors. The decision to write and submit the paper was made by the authors.

Conflict of interest

P.G. declares conflict of interest directly related to the submitted work (Consultancy fees; Covidien); R.D.P. declares conflict of interest directly related to the submitted work (board consultancy and administrative fees; Covidien; paid to R.D.P.’s institution) and conflict of interest not directly related to the submitted work (teaching/lecture honoraria and travel expenses; Covidien); B.Y. declares conflict of interest not directly related to the submitted work (lecture fees; Covidien); F.G. declares conflict of interest directly related to the submitted work (committee participation fees; Covidien; paid to F.G.’s institution); M.B. declares conflict of interest directly related to the submitted work (administrative and data entry fees; Covidien; paid to M.B.’s institution); A.M. declares conflict of interest directly related to the submitted work (administrative and data entry fees; Covidien; paid to A.M.’s institution) and conflict of interest not directly related to the submitted work (travel expenses; Covidien); N.J.S. declares conflict of interest not directly related to the submitted work (teaching/lecture honoraria and travel expenses; Covidien); I.D. declares conflict of interest directly related to the submitted work (board consultancy and administrative fees; Covidien; paid to I.D.’s institution) and conflict of interest not directly related to the submitted work (teaching/lecture honoraria and travel expenses; Covidien).

Ethical approval

This study was conducted in accordance with the declaration of Helsinki and all national and local regulations were adhered to.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Barts Health, Whipps Cross University Hospital, Whipps Cross Rd., Leytonstone, London, E11 1NR, UK

    P. Giordano

  2. Torbay Hospital, Torquay, Devon, UK

    R. D. Pullan

  3. St. Olavs Hospital, Trondheim, Norway

    B. Ystgaard

  4. Umberto I Policlinic, Rome, Italy

    F. Gossetti

  5. Wansbeck Hospital, Ashington, Northumberland, UK

    M. Bradburn

  6. Aberdeen Royal Infirmary, Aberdeen, UK

    A. J. McKinley

  7. Royal Devon & Exeter NHS Foundation Trust, Exeter, Devon, UK

    N. J. Smart & I. R. Daniels

Authors
  1. P. Giordano
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  2. R. D. Pullan
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  3. B. Ystgaard
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  4. F. Gossetti
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  5. M. Bradburn
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  6. A. J. McKinley
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  7. N. J. Smart
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  8. I. R. Daniels
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Corresponding author

Correspondence to P. Giordano.

Additional information

Clinical Trial Registration Number: NCT01214252 (http://www.clinicaltrials.gov).

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Giordano, P., Pullan, R.D., Ystgaard, B. et al. The use of an acellular porcine dermal collagen implant in the repair of complex abdominal wall defects: a European multicentre retrospective study. Tech Coloproctol 19, 411–417 (2015). https://doi.org/10.1007/s10151-015-1307-4

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  • DOI: https://doi.org/10.1007/s10151-015-1307-4

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