Collagen scaffold base corrects pediatric chest defect
MedWire News: A biodegradable collagen scaffold, appears to be an effective solution for reconstructing chest wall defects in infants, case study results indicate.
The reconstructive capabilities of this device are particularly pronounced when used in the presence of an underlying swinging rib, say Mohammed Zamakhshary (The Hospital for Sick Children, Toronto, Ontario, Canada) and co-authors.
They highlight that Surgisis (Cook Biotech Technology, West Lafayette, Indiana, USA) differs from other biologic grafts, because it encourages a healing environment in which vital growths factors are present, and also acts as a bridge between the main chest wall and a rib graft.
This, say the authors, promotes tissue remodeling at the point of defect.
The findings arise from an analysis of the outcomes of three neonates born with chest wall defects. One had Poland syndrome and underwent chest wall repair 4 weeks after birth; the second had a cleft sternum, which was reconstructed 6 weeks after birth; and the third baby had V-shaped sternal defect, which was operated on 6 months after birth.
All repairs were performed with a Surgisis patch, which was sutured into place. Two babies had a swinging rib available for use as the rib graft.
The first baby was followed up for 4 years, the second for 10 months, and the third baby was followed up for 3 years. During this time, no complications occurred in any child, and only one child required further surgical intervention (for pre-existing scoliosis).
Writing in the Journal of Pediatric Surgery, Zamakhshary and co-authors report that increased reconstruction-site stability was evident in the two infants with a swinging rib, as surgeons were able to mobilize, rotate, and suture the rib across the defect site.
The authors say: "The main advantage of this technique is the growth capacity of the scaffold and native rib, which is particularly important for the pediatric population.
"In addition, the only partially detached swinging rib is believed to provide more stability than the completely mobilized, more distant, unilateral or contralateral rib graft."
Zamakhshary et al conclude that although the case study results are encouraging, additional studies will be required to determine if Surgisis is a long-term solution for pediatric chest wall defects.
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By Lauretta Ihonor