TITLE:
Experience with Porcine Acellular Dermal Collagen Mesh (Permacol™ Surgical Implant) in Chest Wall Reconstruction after Resection for Rib Osteomyelitis
AUTHORS:
Claudia Hannele Mazzetti, Patrick Carlier, Alexis Therasse, Jean Lemaitre
KEYWORDS:
Osteomyelitis, Permacol, Rib, Thoracotomy, Thoracic Wall, Chest Wall
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.5 No.2,
June
9,
2015
ABSTRACT: Chest wall reconstruction after rib resection is essential to ensuring chest wall stability, avoiding flail chest and pulmonary hernia, and improving pulmonary function. Traditionally, a synthetic mesh and a musculocutaneous flap have been used to bridge the chest wall defect. However, a risk of secondary prosthesis infection exists. Acellular dermal collagen mesh implants (Permacol™) are indicated for the reconstruction and reformation of human soft connective tissue. A case of a complex chest wall reconstruction after rib resection for osteomyelitis due to staphylococcus aureus infection in a malnourished, immunosuppressed, and methadone-addicted patient is presented. The patient underwent a left posterolateral thoracotomy and chest wall resection, involving three ribs and the soft tissues overlying an infected cutaneous fistula. The chest wall was reconstructed using a 28 × 18 cm piece of porcine sterile acellular dermal collagen mesh. A successful chest wall repair was achieved with no incisional herniation and with complete mesh incorporation, allowing physiologic respiratory movements. A typical wound seroma developed and resorbed over the following months. There was no infection. In conclusion, this case report suggests that Permacol™ surgical implant can be used successfully as an alternative to synthetic mesh in reconstruction of an infected chest wall.