Evaluation of Surgisis for patch repair of abdominal wall defects in children Alana Beres, Emily R. Christison-Lagay, Rodrigo L.P. Romao, Jacob C. Langer ⁎ Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada M5G 1X8 Received 11 January 2012; accepted 26 January 2012 Key words: Porcine small intestinal submucosa; Gastroschisis; Omphalocoele; Ventral hernia; Abdominal wall defects Abstract Background: Abdominal wall defects in children are not always amenable to primary repair and may require a patch. The ideal material has yet to be established. We sought to evaluate our experience using the bioabsorbable material Surgisis (Cook Surgical, Bloomington, IN) for abdominal closure. Methods: A retrospective chart review of abdominal wall defects repaired with Surgisis in our institution from 2000 to 2010 was performed. Data extracted included cause of defect, age at operation, possibility of skin coverage, recurrence, length of follow-up, and rate of wound infection. Results: Thirteen patients were identified. Cause of defect was gastroschisis (n = 2), ventral hernia after diaphragmatic hernia repair (n = 2), and omphalocele (n = 9). At median follow-up of 60 months (range, 10-90), 5 (38%) of 13 patients recurred, and 1 patient recurred twice. All recurrences required subsequent patch closure. Six instances of wound infection required antibiotics. None required patch removal. There was a trend toward more frequent recurrence among infants undergoing patch repair (3/4 recurrences in this group) than neonates (1/4 recurrences) or children older than 18 months (1/5 recurrences). Conclusion: Our data suggest that Surgisis is moderately successful in the repair of pediatric abdominal wall defects. We noted a trend toward a higher recurrence rate in infants. Further studies investigating timing of repair and alternative biosynthetic materials are warranted. © 2012 Elsevier Inc. All rights reserved. Primary closure of abdominal wall defects in children is not always possible. Although many techniques for staged closure have been described, in some cases, an abdominal wall patch may be required. Nonabsorbable materials such as Marlex, silastic sheeting, polypropelene mesh, and Gore-Tex have been tried but can be complicated by infection, erosion into the bowel or through the skin, and the development of adhesions [1-3]. Newer bioabsorbable materials have emerged over recent years, such as porcine small intestine submucosa (Surgisis [Cook Surgical, Bloomington, IN]) and acellular human dermis. Because these products are absorbed by the body and replaced by scar tissue, these patches have the theoretical advantages of growing with the child and avoiding long-term issues such as erosion. We sought to evaluate the experience at our institution using the bioabsorbable material Surgisis. ⁎ Corresponding author. Tel.: +1 416 813 7340; fax: +1 416 813 7477 E-mail address: jacob.langer@sickkids.ca (J.C. Langer). www.elsevier.com/locate/jpedsurg 0022-3468/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2012.01.046 Journal of Pediatric Surgery (2012) 47, 917–919