The novel use of small intestinal submucosal matrix for chest wall reconstruction following Ewing’s tumour resection

Abstract

Chest wall reconstruction following major tumour resection remains a challenging problem in the paediatric population due to the need for growth and development following the repair. Synthetic non-biodegradable grafts and materials have led to asymmetrical growth and significant functional and cosmetic compromise. The ideal graft material should be biological non-immunogenic which enables natural healing and facilitates further growth. Ewing's sarcoma is an uncommon primitive neuroectodermal tumour which rarely occurs in the ribs. However, recent improvements in management have produced a significantly improved survival; increasing the importance of chest wall reconstruction. We prospectively assessed the utilisation of Surgisis (an acellular collagen matrix) as a replacement graft in two children undergoing primary chest wall reconstruction following tumour resection. Surgisis is derived from porcine small intestinal submucosa (SIS) that serves as a template for tissue reconstruction and remodeling. The graft was well tolerated; there was no herniation and it allowed normal symmetrical chest movement and growth to occur. The properties of SIS allows natural collagen growth and compares favourably with marlex mesh and other forms of chest wall reconstruction. We believe its unique properties allow it to act as a suitable framework for chest wall reconstruction allowing chest wall growth and development.

Prognostic Risk Factors for the Development of Scoliosis After Chest Wall Resection for Malignant Tumors in Children

“…Many techniques for the reconstruction of the chest wall have been reported in the literature, including those that use polytetrafluoroethylene, polypropylene 24,25 , dehydrated human dura 26 , bovine pericardium 27 , or porcine small intestinal submucosal matrix 28 . In the present study, various surgical techniques were used for reconstruction and the particular type had no apparent influence on the risk for the development of scoliosis.…”

Understanding Roles of Porcine Small Intestinal Submucosa in Urinary Bladder Regeneration: Identification of Variable Regenerative Characteristics of Small Intestinal Submucosa

“…13 SIS has been demonstrated to be biocompatible and has no adverse response in cross-species transplantations. 14,15 This biomaterial has been used as a supporting scaffold to repair a variety of tissues, including arterial and venous tissues, 13,16,17 tendon, 13,17 and wound-closure 18 in various animal models. 19,20 SIS has been approved by the Food and Drug Administration (FDA) for a variety of clinical applications, including urethral sling for stress urinary incontinence, fistula plugs for rectal, urethral, and vaginal fistulae, inguinal and vental hernias, vaginal defect repairs for cystocele, rectoceles, or enteroceles, and Peyronie's disease repairs.…”

An innovative method of pediatric chest wall reconstruction using Surgisis and swinging rib technique

“…In an older pediatric population, multiple prosthetics have been used for chest wall reconstruction, but there seems to be no consensus on the ideal mesh material for this population. Murphy and Corbally [16] presented 5-and 10-year-old patients who underwent chest wall reconstruction using Surgisis. They were able to provide enough support for ventilation with 8-ply Surgisis in both patients, and no complications occurred [16].…”

“…Murphy and Corbally [16] presented 5-and 10-year-old patients who underwent chest wall reconstruction using Surgisis. They were able to provide enough support for ventilation with 8-ply Surgisis in both patients, and no complications occurred [16]. Soyer et al [17] used dura Neuro-patch or Goretex for chest wall reconstruction after chest wall tumor resection in children aged 2 to 12 years.…”