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Peer-reviewed veterinary case report

Thoracotomy patch repair of large diaphragmatic herniae in a porcine model: a tale of two patches.

Journal:
Pediatric surgery international
Year:
2024
Authors:
McDowell, Dermot T et al.
Affiliation:
Sydney Medical School · Australia

Abstract

PURPOSE: Congenital diaphragmatic herniae (CDH) may require patch closure in 50% of the cases. We assessed a biologic and composite mesh in a&#xa0;porcine&#xa0;CDH model. METHODS: Left sided thoracotomy was performed in 20 pigs. Approximately, 30% of the diaphragm was excised and the patch (Surgisis&#xae; or Parietex&#xae;) inserted to close this defect. The pigs were killed at 6&#xa0;months and the diaphragm was harvested for biomechanical and histological assessment. RESULTS: The mean weight of the pigs at surgery and killing were 6.1&#xa0;kg (4.2-8.4&#xa0;kg) and 94.1&#xa0;kg (80-131&#xa0;kg), respectively. There were two recurrences and three eventrations, all with Surgisis&#xae;. There were less dense lung and abdominal adhesions in the Parietex group (P&#x2009;<&#x2009;0.0001 and 0.025, respectively). The tensile strength of the Surgisis&#xae;, the Parietex&#xae; groups and controls were similar. There was significantly more muscle in-growth in the Parietex&#xae; patch over Surgisis&#xae; (p&#x2009;=&#x2009;0.016). CONCLUSION: Parietex&#xae; and Surgisis&#xae; patches at 6&#xa0;months have a similar tensile strength to normal tissue. All recurrences and eventrations were in the Surgisis&#xae; group. Parietex&#xae; patches demonstrated more muscle in-growth into the patch compared to Surgisis&#xae;. This is the first study utilising Parietex&#xae; composite patch in the repair of large diaphragmatic defects in a porcine model.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/39531056/