Skip to main content

Porcine Acellular Collagen Matrix

Porcine acellular collagen matrix (e.g., Pelvicol, InteXen LP) is a decellularized porcine dermal graft used historically in pelvic organ prolapse and sling surgery as a biological alternative to synthetic mesh.

Composition & Processing​

  • Porcine dermis decellularized through chemical and enzymatic processing
  • Preserves a type I collagen extracellular-matrix scaffold
  • Host cells repopulate and remodel the scaffold over time

Rationale​

Biological grafts were proposed as a middle ground between native tissue and permanent synthetic mesh — providing short-term mechanical support that would be remodeled into native tissue, avoiding permanent-mesh complications.

Evidence​

Randomized and meta-analytic evidence shows no clear advantage over native-tissue repair for pelvic organ prolapse.[1][2]

  • Higher recurrence than permanent mesh
  • Similar anatomic outcomes to native-tissue repair at 2 years
  • Higher cost than native repair

Current Status​

Most biological graft products used historically for POP are no longer commercially available or have been substantially withdrawn from the market. Occasional use persists in specific salvage indications.

References​

1. Glazener CM, Breeman S, Elders A, et al. Mesh, Graft, or Standard Repair for Women Having Primary Transvaginal Anterior or Posterior Compartment Prolapse Surgery (PROSPECT). Lancet. 2017;389(10067):381–392. doi:10.1016/S0140-6736(16)31596-3

2. Yeung E, Baessler K, Christmann-Schmid C, et al. Transvaginal Mesh or Grafts or Native Tissue Repair for Vaginal Prolapse. Cochrane Database of Systematic Reviews. 2024;3:CD012079. doi:10.1002/14651858.CD012079.pub2

See also: Porcine SIS, Bovine Dermal.