Biological Materials for Diaphragmatic Repair: Initial Experiences with the PeriGuard Repair Patch®

Abstract

We consider the PeriGuard Repair Patch® a viable alternative to synthetic materials for diaphragm replacement. Moreover, we advise carrying out cautious follow-up in patients undergoing extensive oncological resection to learn more about the biological behavior of the bovine PeriGuard Repair Patch® after diaphragmatic repair.

Primary Combined Latissimus Dorsi and Serratus Anterior Flap Repair of Right-Sided Congenital Diaphragmatic Agenesis in a Neonate

“…[3][4][5][6][7] Right-sided CDA has a high mortality rate in comparison to right-sided CDH (95-98% versus 50-70%). [2][3][4][5][6][7]9,10 The present report details a unique case of right-sided CDA with complete hemidiaphragmatic agenesis associated with impaired development of the thoracic intercostal muscles and oesophageal mesentery. The defect was repaired using an autologous living bio-tissue flap to facilitate the development of a compliant neo-diaphragm that would provide effective pleuroperitoneal separation.…”

Diaphragmatic rupture: Is management with biological mesh feasible?

“…This is not unlike the concept of an underlay patch in treatment of large abdominal ventral hernias. 16 In cases #2, #3, and #4 there was remaining diaphragmatic defect despite attempts at primary repair. In cases #3 and #4 there was a contaminated field with bowel perforation in case #3 and empyema and bile spillage in case #4.…”

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“…5 It demonstrated high tensile strength, elasticity, and was easy to manipulate. The patch has good biocompatibility, allowing ingrowth of natural tissue and minimal risk of infection.…”

“…The patch has good biocompatibility, allowing ingrowth of natural tissue and minimal risk of infection. 5 These qualities, combined with the possibility of microtears in a reoperative setting, prompted the selection of a bovine pericardium to repair the DH in this patient. Although the long-term outcomes remain uncertain, this case demonstrates the successful use of a bovine pericardium to repair a DH.…”