gms | German Medical Science

Introduction: Biological scaffold materials composed of mammalian extracellular matrix (ECM) are commonly used for the surgical repair. Under the problematic aspects of many conventional operative methods Surgisis (SIS) ,a “Small Intestinal Submucosa” biodegradable tissue, has been applied to the partial functional organic replacement in our clinic over the last eight years.

Materials and methods: SIS is a biomaterial from the small intestine of the pig, which COOK.Co. offers in a compatible form. The endproduct is a three-dimensional Extra-Cellular Matrix (ECM) consisting of collagen, non-collagenic proteins and other biomolecules including glycoproteins. 32 children aged 1 day to fourteen years with different starting indications have so far been treated with SIS. 10 children have been operated on contracted, neurogenic bladders or bladder exstrophies and 8 on gastroschisis. Diaphragma hernias,dura replacement, long gap esophageal atresia in newborn age and rectal stump empyemas as well as fistulas have been further indications. After initial preparation a 4-layer patch with 4x0 respectively 5x0 PDS continous and approx. 5mm overlapping edge, was attached to prevent contraction. Impermeability was achieved with a tachofleece segment (BAXTER) and collagen gluten.

Results:

1.

The postoperative progress showed no serious complications in all operations. The children with non-neurogenic bladders micturated spontaneously and were increasingly free of residual urine after catheter removal. Above all the esophageal and rectal replacements had not any limitations.

2.

The practicable histological and immunohistochemical examinations by means of ASMA and DESMIN as smooth muscular antibodies showed evidence of the morphological integration of the transplant in all layers.

3.

The histo-pathological findings conform with our experimental,clinical,sonographic, endoscopic and functional results.

Conclusion: The application of Surgisis (SIS) permits new multiple options for the morphological and functional replacement of different organs. According to the assessments to date the “SIS” transplant seems to be superior to conventional techniques.