Shanbhag A, Friedman H I, Augustine J, von Recum A F
Department of Bioengineering, Clemson University, SC 29634-0905.
Ann Plast Surg. 1990 Jan;24(1):32-9. doi: 10.1097/00000637-199001000-00006.
Autogenous rib cartilage and silicone rubber are materials currently used for ear reconstruction. Increased morbidity and operative time with rib cartilage grafts and a high rate of extrusion with silicone implants render them less than ideal for reconstruction of the human ear. The purpose of the current investigation is to determine the efficacy of porous polyethylene as an alternative synthetic material for ear reconstruction. Porous polyethylene and silicone rubber discs of equal sizes in two thicknesses were implanted in lieu of the cartilage in the external ear of eight baboons. Histological evaluation of the sites after nine weeks revealed excellent anchorage of the thin porous polyethylene implants (1.5 mm) in the surrounding tissues. Silicone rubber implants, however, were encapsulated in a thickened granulation tissue capsule. When thicker implants (3.0 mm) were used, exposure or extrusion occurred in all cases. Porous polyethylene implants demonstrated only partial exposure; half of the silicone rubber implants were extruded; and the other two silicone rubber implants were almost completely extruded. Porous polyethylene was thus better incorporated into the soft tissues than silicone rubber as long as the overlying soft tissues were not stressed by an oversized implant or inadequate soft tissue coverage.
自体肋软骨和硅橡胶是目前用于耳部重建的材料。肋软骨移植会增加发病率和手术时间，而硅橡胶植入物的挤出率很高，这使得它们在人类耳部重建方面并不理想。本研究的目的是确定多孔聚乙烯作为耳部重建替代合成材料的有效性。将两种厚度相同尺寸的多孔聚乙烯和硅橡胶圆盘植入八只狒狒的外耳软骨部位。九周后对这些部位进行组织学评估发现，薄的多孔聚乙烯植入物（1.5毫米）在周围组织中固定良好。然而，硅橡胶植入物被包裹在增厚的肉芽组织囊中。当使用较厚的植入物（3.0毫米）时，所有病例均出现暴露或挤出。多孔聚乙烯植入物仅出现部分暴露；一半的硅橡胶植入物被挤出；另外两个硅橡胶植入物几乎完全被挤出。因此，只要覆盖的软组织不因植入物过大或软组织覆盖不足而受压，多孔聚乙烯比硅橡胶能更好地融入软组织。
