TY - JOUR
T1 - Permacol
T2 - a potential biologic patch alternative in congenital diaphragmatic hernia repair
AU - Mitchell, Ian C.
AU - Garcia, Nilda M.
AU - Barber, Robert
AU - Ahmad, Naveed
AU - Hicks, Barry A.
AU - Fischer, Anne C.
PY - 2008/12
Y1 - 2008/12
N2 - Purpose: Recurrence is a well-known complication after patch repair of congenital diaphragmatic hernia (CDH). We propose that a newer, "bioprosthetic" material may lower recurrence rates. The purpose of this study is to compare outcomes of CDH repair with synthetic Gore-Tex (W. L. Gore and Associates, Neward, Del) to the bioprosthetic Permacol (Tissue Science Laboratories Inc, Andover, Mass). Methods: We performed a retrospective review of 100 consecutive patients with CDH with survival more than 30 days at Children's Medical Center of Dallas (Dallas, Tex) from 1999 to 2007. The incidence and timing of recurrence, as well as comorbidities were assessed. Results: Primary repair was performed in 63 patients and patch repair in 37, divided between Gore-Tex (29) and Permacol (8). Overall recurrences were as follows: 1 (2%), 8 (28%), and 0 in the primary, Gore-Tex, and Permacol groups, respectively. Median follow-up was 57 months for Gore-Tex and 20 months for Permacol. Median time to recurrence in the Gore-Tex group was 12 months, with no Permacol recurrences. Both the Gore-Tex and Permacol groups had similar comorbidities, including prematurity, congenital heart disease (76% and 63%, respectively), and the need for extracorporeal membrane oxygenation support (38% and 25%). Conclusion: Our results suggest that Permacol may have lower recurrence rates compared to Gore-Tex and is a promising alternative biologic graft for CDH repair.
AB - Purpose: Recurrence is a well-known complication after patch repair of congenital diaphragmatic hernia (CDH). We propose that a newer, "bioprosthetic" material may lower recurrence rates. The purpose of this study is to compare outcomes of CDH repair with synthetic Gore-Tex (W. L. Gore and Associates, Neward, Del) to the bioprosthetic Permacol (Tissue Science Laboratories Inc, Andover, Mass). Methods: We performed a retrospective review of 100 consecutive patients with CDH with survival more than 30 days at Children's Medical Center of Dallas (Dallas, Tex) from 1999 to 2007. The incidence and timing of recurrence, as well as comorbidities were assessed. Results: Primary repair was performed in 63 patients and patch repair in 37, divided between Gore-Tex (29) and Permacol (8). Overall recurrences were as follows: 1 (2%), 8 (28%), and 0 in the primary, Gore-Tex, and Permacol groups, respectively. Median follow-up was 57 months for Gore-Tex and 20 months for Permacol. Median time to recurrence in the Gore-Tex group was 12 months, with no Permacol recurrences. Both the Gore-Tex and Permacol groups had similar comorbidities, including prematurity, congenital heart disease (76% and 63%, respectively), and the need for extracorporeal membrane oxygenation support (38% and 25%). Conclusion: Our results suggest that Permacol may have lower recurrence rates compared to Gore-Tex and is a promising alternative biologic graft for CDH repair.
KW - Congenital diaphragmatic hernia
KW - Gore-Tex
KW - Permacol
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=56449123824&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=56449123824&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2008.08.040
DO - 10.1016/j.jpedsurg.2008.08.040
M3 - Article
C2 - 19040926
AN - SCOPUS:56449123824
SN - 0022-3468
VL - 43
SP - 2161
EP - 2164
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 12
ER -