Uysal Afşin, Kayiran Oğuz, Karaaslan Onder, Ulusoy Mustafa Gürhan, Koçer Uğur, Atalay Fatma Oz, Ustün Hüseyin
Ankara Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Clinic, Ankara, Turkey.
J Craniofac Surg. 2006 Nov;17(6):1129-36. doi: 10.1097/01.scs.0000244913.75102.12.
Numerous autogenous and alloplastic materials have been used for restoration of contour deformities of the face. Alloplastic materials have come into use to replace autogeneous bone grafts because bone grafts are associated with donor site morbidity, resorption and difficulty in shaping. Porous high-density polyethylene (HDPPE) is a commercial product which is nonallergenic, nonantigenic, noncarcinogenic and nonresorbable, highly stable and somewhat flexible. It has pores of 125-250 mum which enable tissue ingrowth resulting in firm attachment and integration of the implant to the surrounding tissues. In this study we aimed to evaluate the fate of the exposed implants and proposed a method to manage the exposed medpor implants. Twenty rats were used for this experimental study. Three phases involving the implantation, exposition, and the closure of the implants were held respectively. Closure was performed in two groups: 1) After perforating the exposed implants; 2) Without perforating the exposed implants. No serious complications were seen. Perforated exposed implants when covered with flaps rather than grafts could be covered. Exposed implants were not covered easily as indicated by the previous studies. This study demonstrates that early closure of perforated implants with flaps can give the best clinical results when exposed implants are covered in a short period after exposition so that the ingrown fibrous tissues are still intact. We believe that grafting of the exposed medpor implants cannot be effective either in early or late period. Perforating the exposed implants yield successful results as ingrowth of the tissues are enabled.
许多自体材料和异体材料已被用于面部轮廓畸形的修复。由于骨移植存在供区并发症、吸收以及塑形困难等问题，异体材料已开始用于替代自体骨移植。多孔高密度聚乙烯（HDPPE）是一种商业产品，具有无致敏性、无抗原性、无致癌性且不可吸收、高度稳定且略有柔韧性的特点。它有125 - 250微米的孔隙，能使组织向内生长，从而使植入物与周围组织牢固附着并整合。在本研究中，我们旨在评估暴露植入物的转归，并提出一种处理暴露的Medpor植入物的方法。本实验研究使用了20只大鼠。分别进行了植入、暴露和植入物闭合三个阶段。闭合分为两组进行：1）在暴露的植入物上打孔后；2）不对暴露的植入物打孔。未观察到严重并发症。当用皮瓣而非移植物覆盖时，打孔的暴露植入物可以被覆盖。如先前研究所表明的，暴露的植入物不容易被覆盖。本研究表明，当暴露的植入物在暴露后短时间内被覆盖，使得向内生长的纤维组织仍然完整时，用皮瓣早期闭合打孔的植入物能获得最佳临床效果。我们认为，对暴露的Medpor植入物进行移植无论在早期还是晚期都不会有效。对暴露的植入物进行打孔能取得成功结果，因为这样能促进组织向内生长。
