Losken H Wolfgang, van Aalst John A, Mooney Mark P, Godfrey Virginia L, Burt Tripti, Teotia Sumeet, Dean Shay B, Moss Jonathan R, Rahbar Reza
Division of Plastic and Reconstructive Surgery, University of North Carolina at Chapel Hill, North Carolina 27599-7195, USA.
J Craniofac Surg. 2008 May;19(3):748-56. doi: 10.1097/SCS.0b013e31816aab24.
Biodegradable plates and screws are recommended for use in surgery of the craniofacial skeleton of children. To be effective and not interfere with growth of the child's skull, the plates must biodegrade sufficiently to release the holding power of the plate and screw within 1 year. It is also essential that excessive foreign body reaction and cyst formation does not occur when the plates and screws biodegrade. The purpose of this experimental study was to evaluate the rate of biodegradation of Inion CPS Baby biodegradable plates and screws under different clinical circumstances in the rabbit craniofacial skeleton and evaluate their efficacy for use in pediatric craniofacial surgery. Foreign body reaction would be evaluated. Inion baby plates and screws were tested in a rabbit model. Plates were applied to the frontal bone, over a bony defect of the parietal bone, to a nasal bone fracture, and inserted in the subcutaneous space over the occipital bone in thirty 6-week-old rabbits. Six rabbits were euthanized at 9, 12, 15, and 18 months' postoperative time point and examined for residual plates and screws. Bone from each surgical site was excised, fixed by immersion in 10% neutral-buffered formalin, decalcified in Immunocal solution, and examined by 7-microm paraffin sections stained with hematoxylin and eosin. At 9 months, the plates and screws had effectively biodegraded and no longer had holding power on the bones. Fragmentation of the implant material was noted. Residual implant material was still present on gross and histologic examination in rabbits at 9, 12, 15, and 18 months. Residue of a screw was still palpable in 1 rabbit at 18 months. There was no evidence of cyst formation in any of the examined specimens. Macrophages and giant cells were present in most of the specimens at 9, 12, 15, and 18 months. Findings from the current study revealed a relative short resorption time (9 mo) and normal inflammatory sequelae in an adult rabbit model. These findings suggest that these plates may be used safely in fixing the pediatric craniofacial skeleton.
可生物降解的接骨板和螺钉被推荐用于儿童颅面骨骼手术。为了有效且不干扰儿童颅骨的生长,接骨板必须充分生物降解,以便在1年内释放接骨板和螺钉的固定力。同样重要的是,当接骨板和螺钉生物降解时,不会发生过度的异物反应和囊肿形成。本实验研究的目的是评估Inion CPS Baby可生物降解接骨板和螺钉在兔颅面骨骼不同临床情况下的生物降解率,并评估它们在小儿颅面外科手术中的有效性。将评估异物反应。Inion婴儿接骨板和螺钉在兔模型中进行测试。将接骨板应用于30只6周龄兔子的额骨、顶骨骨缺损上方、鼻骨骨折处,并插入枕骨上方的皮下空间。在术后9、12、15和18个月的时间点对6只兔子实施安乐死,并检查残留的接骨板和螺钉。从每个手术部位切取骨头,浸入10%中性缓冲福尔马林中固定,在Immunocal溶液中脱钙,并用苏木精和伊红染色的7微米石蜡切片进行检查。在9个月时,接骨板和螺钉已有效生物降解,不再对骨骼具有固定力。注意到植入材料有碎裂。在9、12、15和18个月时,在兔子的大体和组织学检查中仍存在残留的植入材料。在18个月时,1只兔子中仍可触及一枚螺钉的残留物。在任何检查的标本中均未发现囊肿形成的证据。在9、12、15和18个月时,大多数标本中存在巨噬细胞和巨细胞。本研究的结果显示,在成年兔模型中吸收时间相对较短(9个月)且炎症后遗症正常。这些结果表明,这些接骨板可安全用于固定小儿颅面骨骼。