Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Sep 14, 2009; 15(34): 4331-4333
Published online Sep 14, 2009. doi: 10.3748/wjg.15.4331
Rejection of Permacol® mesh used in abdominal wall repair: A case report
Franchesca T Wotton, Jacob A Akoh
Franchesca T Wotton, Jacob A Akoh, Surgery & Renal Services Directorate, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, PL6 8DH, United Kingdom
Author contributions: Wotton FT summarised the case and contributed to writing paper; Akoh JA wrote the paper.
Correspondence to: Jacob A Akoh, Mr, Consultant General Surgeon, Level 04, Derriford Hospital, Plymouth, PL6 8DH, United Kingdom. jacob.akoh@phnt.swest.nhs.uk
Telephone: +44-1752-439798 Fax: +44-1752-774651
Received: June 10, 2009
Revised: August 12, 2009
Accepted: August 19, 2009
Published online: September 14, 2009
Abstract

Permacol® mesh has shown promise when used in abdominal wall repair, especially in the presence of a contaminated surgical field. This biomaterial, derived from porcine dermis collagen, has proposed advantages over synthetic materials due to increased biocompatibility and reduced foreign body reaction within human tissues. However, we present a case report describing a patient who displayed rejection to a Permacol® mesh when used in the repair of abdominal wound dehiscence following an emergency laparotomy. Review of the English language literature using PubMed and Medline, showed only two previously published cases of explantation of Permacol® due to sepsis or wound breakdown. The authors believe this is the first case of severe foreign body reaction leading to rejection of Permacol®. Both animal and human studies show conflicting evidence of biocompatibility. There are several reports of successful use of Permacol® to repair complex incisional herniae or abdominal walls in the presence of significant contamination. It appears from the literature that Permacol® is a promising material, but as we have demonstrated, it has the potential to evoke a foreign body reaction and rejection in certain subjects.

Keywords: Abdominal wound closure, Permacol rejection, Foreign body reaction, Biocompatibility