Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
권호 표지
DOI QR코드

DOI QR Code

The Efficacy of Bioabsorbable Mesh in Craniofacial Trauma Surgery

  • Choi, Won Chul (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Choi, Hyun Gon (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Jee Nam (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Lee, Myung Cheol (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Shin, Dong Hyeok (Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine) ;
  • Kim, Soon Heum (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Kim, Cheol Keun (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine) ;
  • Jo, Dong In (Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine)
  • Received : 2016.05.24
  • Accepted : 2016.07.26
  • Published : 2016.09.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The ultimate goal of craniofacial reconstructive surgery is to achieve the most complete restoration of facial functions. A bioabsorbable fixation system which does not need secondary operation for implant removal has been developed in the last decade. The purpose of this study is to share the experience of authors and to demonstrate the efficacy of bioabsorbable mesh in a variety of craniofacial trauma operations. Methods: Between October 2008 and February 2015, bioabsorbable meshes were used to reconstruct various types of craniofacial bone fractures in 611 patients. Any displaced bone fragments were detached from the fracture site and fixed to the mesh. The resulting bone-mesh complex was designed and molded into an appropriate shape by the immersion in warm saline. The mesh was molded once again under simultaneous warm saline irrigation and suction. Results: In all patients, contour deformities were restored completely, and bone segments were fixed properly. The authors found that the bioabsorbable mesh provided rigid fixation without any evidence of integrity loss on postoperative computed tomography scans. Conclusion: Because bioabsorbable meshes are more flexible than bioabsorbable plates, they can be molded and could easily reconstruct the facial bone in three dimensions. Additionally, it is easy to attach bone fragments to the mesh. Bioabsorbable mesh and screws is effective and can be easily applied for fixation in various craniofacial trauma reconstructive scenarios.

Keywords

References

  1. Assael LA. Considerations in rigid internal fixation of midface trauma. Oral Maxillofac Surg Clin North Am 1990;2:103-19.
  2. Spiessl B. Internal fixation of the mandible: a manual of AO/ASIF principles. Berlin: Springer Berlin Heidelberg; 1989.
  3. Yaremchuk MJ, Gruss JS, Manson PN. Rigid fixation of the craniomaxillofacial skeleton. Boston: Butterworth-Heinemann; 1992.
  4. Prein J, Arbeitsgemeinschaft fur Osteosynthesefragen. Manual of internal fixation in the cranio-facial skeleton: techniques recommended by the AO/ASIF-Maxillofacial Group. New York: Springer; 1998.
  5. Goldstein JA, Quereshy FA, Cohen AR. Early experience with biodegradable fixation for congenital pediatric craniofacial surgery. J Craniofac Surg 1997;8:110-5. https://doi.org/10.1097/00001665-199703000-00009
  6. Habal MB. Absorbable, invisible, and flexible plating system for the craniofacial skeleton. J Craniofac Surg 1997;8:121-6. https://doi.org/10.1097/00001665-199703000-00011
  7. Kumar AV, Staffenberg DA, Petronio JA, Wood RJ. Bioabsorbable plates and screws in pediatric craniofacial surgery: a review of 22 cases. J Craniofac Surg 1997;8:97-9. https://doi.org/10.1097/00001665-199703000-00006
  8. Suuronen R, Pohjonen T, Vasenius J, Vainionpaa S. Comparison of absorbable self-reinforced multilayer poly-l-lactide and metallic plates for the fixation of mandibular body osteotomies: an experimental study in sheep. J Oral Maxillofac Surg 1992;50:255-62. https://doi.org/10.1016/0278-2391(92)90322-Q
  9. Francel TJ, Birely BC, Ringelman PR, Manson PN. The fate of plates and screws after facial fracture reconstruction. Plast Reconstr Surg 1992;90:568-73. https://doi.org/10.1097/00006534-199210000-00004
  10. Kim JH, Shin DW, Choi TH, Son DG, Han KH. The importance of septoplasty in the treatment of nasal bone and grade i septal fracture: estimation with acoustic rhinometry. J Korean Soc Plast Reconstr Surg 2010;37:626-32.
  11. Orringer JS, Barcelona V, Buchman SR. Reasons for removal of rigid internal fixation devices in craniofacial surgery. J Craniofac Surg 1998;9:40-4. https://doi.org/10.1097/00001665-199801000-00009
  12. Schmidt BL, Perrott DH, Mahan D, Kearns G. The removal of plates and screws after Le Fort I osteotomy. J Oral Maxillofac Surg 1998;56:184-8. https://doi.org/10.1016/S0278-2391(98)90865-5
  13. Beals SP, Munro IR. The use of miniplates in craniomaxillofacial surgery. Plast Reconstr Surg 1987;79:33-8. https://doi.org/10.1097/00006534-198701000-00005
  14. Lin KY, Bartlett SP, Yaremchuk MJ, Grossman RF, Udupa JK, Whitaker LA. An experimental study on the effect of rigid fixation on the developing craniofacial skeleton. Plast Reconstr Surg 1991;87:229-35. https://doi.org/10.1097/00006534-199102000-00003
  15. Yaremchuk MJ, Fiala TG, Barker F, Ragland R. The effects of rigid fixation on craniofacial growth of rhesus monkeys. Plast Reconstr Surg 1994;93:1-10. https://doi.org/10.1097/00006534-199401000-00001
  16. Fearon JA, Munro IR, Bruce DA. Observations on the use of rigid fixation for craniofacial deformities in infants and young children. Plast Reconstr Surg 1995;95:634-7. https://doi.org/10.1097/00006534-199504000-00002
  17. Yu JC, Bartlett SP, Goldberg DS, Gannon F, Hunter J, Habecker P, et al. An experimental study of the effects of craniofacial growth on the long-term positional stability of microfixation. J Craniofac Surg 1996;7:64-8. https://doi.org/10.1097/00001665-199601000-00014
  18. Rehm KE, Helling HJ, Claes L. Report of the Biodegradable Implants Study Group. Aktuelle Traumatol 1994;24:70-3.
  19. Baek WI, Kim HK, Kim WS, Bae TH. Comparison of absorbable mesh plate versus titanium-dynamic mesh plate in reconstruction of blow-out fracture: an analysis of long-term outcomes. Arch Plast Surg 2014;41:355-61. https://doi.org/10.5999/aps.2014.41.4.355
  20. Tabrizi R, Ozkan TB, Mohammadinejad C, Minaee N. Orbital floor reconstruction. J Craniofac Surg 2010;21:1142-6. https://doi.org/10.1097/SCS.0b013e3181e57241
  21. Kim CH, Kim DH, Kim DH, Song SY. Treatment of frontal sinus fracture using bioabsorbable mesh plates. J Craniofac Surg 2012;23:549-51. https://doi.org/10.1097/SCS.0b013e3182418f40
  22. Shin DH, Kim DJ, Kim SY, Hwang EA, Choi HG, Kim SH, et al. Rigid fixation using bioabsorbable mesh and screws in facial bone fracture. J Korean Soc Plast Reconstr Surg 2010;37:717-20.

Cited by

  1. Delayed reconstruction of posttraumatic facial deformities vol.61, pp.12, 2018, https://doi.org/10.5124/jkma.2018.61.12.740
  2. Clinical usefulness of fixation of absorbable implants with cyanoacrylate in comminuted fractures of the maxilla vol.20, pp.4, 2016, https://doi.org/10.7181/acfs.2019.00325