Small intestinal submucosa (Surgisis) as a bioactive prosthetic material for repair of abdominal wall fascial defect

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40 Citations (Scopus)

Abstract

There are adequate experimental data to support the efficacy of Surgisis as a bioactive prosthetic material for the repair of abdominal wall fascial defects, because it is a naturally occurring extracellular matrix that is easily absorbed, supports early and abundant new vessel growth, and serves as a scaffold for the constructive remodeling of fascial and related tissues. Clinically, Surgisis, as a mesh graft material of choice for the repair of abdominal wall or inguinal hernias in contaminated or infected sites and in the pediatric population, showed no chronic infection or hernia recurrence during a relatively short-term follow-up. Although Surgisis is significantly more expensive than polypropylene mesh (Surgisis is $695 and polypropylene mesh is $82 for a 13 × 15-cm section), the cost of the Surgisis may be justified by obviating the need for a second surgical procedure, for example, to remove infected polypropylene mesh placed on a contaminated setting, to repair a recurrent hernia secondary to placement of an absorbable mesh, or to repair a recurrent hernia after an initial repair. The Surgisis may also be used to manage abdominal wall weakness after TRAM flap surgery, since no correlation has been demonstrated between abdominal strength and use of onlay polypropylene mesh in the abdominal donor-site closure and Surgisis may be more resistant to bacterial infection than any other nonabsorbable synthetic mesh. Therefore, Surgisis can be used as either an inlay or an onlay graft to repair abdominal wall fascial defects in contaminated or infected fields, in complicated reoperative hernia cases, in pediatric patients, or at TRAM flap donor sites. Compared with AlloDerm, a human acellular dermal matrix, Surgisis serves as a scaffold for host tissue regeneration as well, but it will be completely degraded and replaced by the host tissue over time. Either Surgisis or AlloDerm may be used safely in contaminated or infected fields when an abdominal wall fascial defect needs to be repaired. Long-term study may still be warranted to determine the efficacy of Surgisis to replace common prosthetic materials such as polypropylene mesh for the repair of abdominal wall fascial defects.

Original languageEnglish (US)
Pages (from-to)2127-2131
Number of pages5
JournalPlastic and Reconstructive Surgery
Volume115
Issue number7
DOIs
StatePublished - Jun 2005
Externally publishedYes

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Abdominal Wall
Polypropylenes
Hernia
Inlays
Repair Material
surgisis
Acellular Dermis
Tissue Donors
Pediatrics
Abdominal Hernia
Tissue Scaffolds
Transplants
Inguinal Hernia
Bacterial Infections
Extracellular Matrix
Regeneration
Costs and Cost Analysis
Recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Small intestinal submucosa (Surgisis) as a bioactive prosthetic material for repair of abdominal wall fascial defect",
abstract = "There are adequate experimental data to support the efficacy of Surgisis as a bioactive prosthetic material for the repair of abdominal wall fascial defects, because it is a naturally occurring extracellular matrix that is easily absorbed, supports early and abundant new vessel growth, and serves as a scaffold for the constructive remodeling of fascial and related tissues. Clinically, Surgisis, as a mesh graft material of choice for the repair of abdominal wall or inguinal hernias in contaminated or infected sites and in the pediatric population, showed no chronic infection or hernia recurrence during a relatively short-term follow-up. Although Surgisis is significantly more expensive than polypropylene mesh (Surgisis is $695 and polypropylene mesh is $82 for a 13 × 15-cm section), the cost of the Surgisis may be justified by obviating the need for a second surgical procedure, for example, to remove infected polypropylene mesh placed on a contaminated setting, to repair a recurrent hernia secondary to placement of an absorbable mesh, or to repair a recurrent hernia after an initial repair. The Surgisis may also be used to manage abdominal wall weakness after TRAM flap surgery, since no correlation has been demonstrated between abdominal strength and use of onlay polypropylene mesh in the abdominal donor-site closure and Surgisis may be more resistant to bacterial infection than any other nonabsorbable synthetic mesh. Therefore, Surgisis can be used as either an inlay or an onlay graft to repair abdominal wall fascial defects in contaminated or infected fields, in complicated reoperative hernia cases, in pediatric patients, or at TRAM flap donor sites. Compared with AlloDerm, a human acellular dermal matrix, Surgisis serves as a scaffold for host tissue regeneration as well, but it will be completely degraded and replaced by the host tissue over time. Either Surgisis or AlloDerm may be used safely in contaminated or infected fields when an abdominal wall fascial defect needs to be repaired. Long-term study may still be warranted to determine the efficacy of Surgisis to replace common prosthetic materials such as polypropylene mesh for the repair of abdominal wall fascial defects.",
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