Purpose: Repair of complex hernias with synthetic mesh is associated with a significant complication rate, which may necessitate mesh removal. Recent studies have reported good results with the use of collagen-based prosthesis for complicated or infected abdominal hernias. The aim of our study was to evaluate an initial experience using Permacol™ for the repair of complex incisional and parastomal hernias. Methods: A retrospective study of patients with massive, recurrent, complex, or infected incisional and hernias who underwent repair with Permacol™ at a tertiary referral centre was performed. Results: Between 2003 and 2007, 15 patients underwent repair of complex massive or recurrent hernias with Permacol™. Patients were followed up for a median of 377 days (range 85-1905). 16 postoperative complications developed in 11 patients. Two patients developed a recurrence and two patients developed fistulae. No patient has an active infection or required removal of the Permacol™. There have been no deaths. Conclusions: There is increasing evidence that Permacol mesh can be safely used for complex and contaminated hernia repairs with acceptable overall results. © 2009 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.
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