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Fri Jan 4 14:46:26 GMT 2008

I have used both Surgisis and Alloderm.  I started with Surgisis a few years ago because I needed a biologic and it was significantly less expensive than Alloderm.  I have since abandoned its use because of many problems with seromas, elevated white counts and fever with no other source, and too many cases of rapid dissolution of the product.  I do still have some patients that are 3-5 years out with excellent results though.  I have only been using Alloderm for 18 months.  I switched to Alloderm because it has the most data and longest follow-ups.  Unfortunately, it costs big bucks!  However, I have one older gentleman that never incorporated the stuff.  I think he is the problem rather than the product because he has failed every hernia operation no matter who does it or what material is used (no, he is not a smoker and has no medical issues).  I now also have another recurrance in yet another very complicated patient who is 11 months out.  I have not tried any of the other products such as Permacol or Collamend.  I also have to admit that I use Alloderm only in the "problem" patients and so if you consider that, I think it is working as well as could be expected.  Biologically, I think uncrosslinked is better but there is no head-to-head comparison of the products.  It is becoming increasingly difficult for the surgeon to navigate this field because of all the "noise".  There are so many products and there are very real differences.  However, how to know which attributes are the most important?  What I can say about Alloderm is that my patients seem to have a lot less pain than with synthetic meshes and Surgisis.  Also, when it fails and you have to reoperate, there do not seem to be any issues with adhesions or other inflammatory messes.  Since no company is going to fund a study of all the products, it sure would be nice if there was some type of registry we could enter our patients into for follow up and pooled results.

Joan Pellegrini, MD, FACS
Eastern Maine Medical Center
Director, Trauma Program
Co-Director, ICU

417 State Street 
Webber West #340
Bangor, ME 04401

207-973-4949 office
207-973-4466 fax
207-356-9291 cell

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