Rejection of Permacol~ mesh used in abdominal wall repair:A case report

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.