Winkler Andrew A, Soler Zachary M, Leong Paul L, Murphy Ashley, Wang Tom D, Cook Ted A
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Colorado-Denver, Aurora, CO 80045, USA.
Arch Facial Plast Surg. 2012 Nov;14(6):437-41. doi: 10.1001/archfacial.2012.583.
To evaluate the incidence of infection and extrusion of porous high-density polyethylene (pHDPE) and expanded polytetrafluoroethylene (ePTFE) implants used in rhinoplasty at a high-volume, academic facial plastic surgery practice.
A total of 662 rhinoplasty procedures performed by 3 faculty surgeons from 1999 to 2008 were retrospectively reviewed. Patient demographics, medical comorbidities, operative details, and postoperative course findings were collected from patient records.
The incidence of postoperative infection was 2.8% (19 of 662 patients). In each case of infection, alloplastic material had been used. Infections occurred in 1 in 5 rhinoplasty procedures in which pHDPE implants were used. In patients in whom ePTFE was used alone, the infection rate was 5.3%. Exposure developed in 12% of patients in whom an alloplast was used during surgery. Factors notably not associated with infection on bivariate analysis included sex, surgeon, purpose of procedure (functional vs cosmetic), current tobacco use, or history of cocaine use (P > .05 for all).
To our knowledge, this study represents the largest evaluation of the use of pHDPE implants in rhinoplasty to date. Our findings are in contrast to those of previous studies regarding the use of pHDPE in rhinoplasty and parallel to those regarding the use of ePTFE. Caution is strongly recommended when considering the use of pHDPE in rhinoplasty.
在一家大型学术性面部整形手术机构，评估隆鼻术中使用的多孔高密度聚乙烯（pHDPE）和膨体聚四氟乙烯（ePTFE）植入物的感染率和外露率。
回顾性分析1999年至2008年3名外科教员医生共进行的662例隆鼻手术。从患者记录中收集患者人口统计学资料、合并症、手术细节及术后病程结果。
术后感染率为2.8%（662例患者中有19例）。每例感染病例均使用了异体材料。在使用pHDPE植入物的隆鼻手术中，感染发生率为五分之一。单独使用ePTFE的患者，感染率为5.3%。手术中使用异体材料的患者，12%出现了植入物外露。双变量分析中显著与感染无关的因素包括性别、外科医生、手术目的（功能性与美容性）、当前吸烟情况或可卡因使用史（所有P值均>.05）。
据我们所知，本研究是迄今为止对隆鼻术中使用pHDPE植入物的最大规模评估。我们的研究结果与之前关于隆鼻术中使用pHDPE的研究结果相反，与使用ePTFE的研究结果相似。在考虑在隆鼻术中使用pHDPE时，强烈建议谨慎行事。
