Lee Hyun Rok, Shin Hea Kyeong, Lee Dong Lark, Jung Gyu Yong
Department of Plastic and Reconstructive Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
Arch Craniofac Surg. 2016 Dec;17(4):229-232. doi: 10.7181/acfs.2016.17.4.229. Epub 2016 Dec 23.
None of the reports of delayed infection mentioned a latent period exceeding 13 months. we report an infection that developed 18 months after implantation of an absorbable plate. A 16-year-old adolescent girl had undergone reduction and fixation with an absorbable plate for Lefort I and zygomaticomaxillary complex fractures 18 months prior at our hospital. In her most recent hospital visit as an outpatient, abscess was observed in periocular area. Computed tomography revealed sinusitis with an abscess above the infraorbital rim. Wound culture yielded methicillin-resistant . Despite conservative treatments, wound state did not improve. Therefore, our department decided to perform surgery. Absorbable plate had been mostly absorbed but remained a bit. Bony depression of infraorbital rim and mucosal exposure of maxillary sinus anterior wall were observed. After the surgery, the patient recovered. We believe that the reason the wound infection and sinusitis manifested at the same time is because of several factor such as alcohol abuse, smoking, and mucosal exposure of maxillary sinus anterior wall. Absorbable plate takes 9 months to 3 years to be completely absorbed, thus we suggest studies with a follow-up of at least 3 years be undertaken to determine the outcomes of patients with many risk factors.
在所有关于延迟感染的报告中，均未提及潜伏期超过13个月的情况。我们报告了1例在植入可吸收接骨板18个月后发生的感染。1名16岁少女18个月前在我院因勒福I型骨折和颧上颌复合体骨折接受了可吸收接骨板复位固定术。在她最近一次门诊就诊时，发现眼周区域有脓肿。计算机断层扫描显示鼻窦炎伴眶下缘上方脓肿。伤口培养出耐甲氧西林……尽管进行了保守治疗，但伤口状况并未改善。因此，我科决定进行手术。可吸收接骨板大部分已被吸收，但仍残留一点。观察到眶下缘骨质凹陷和上颌窦前壁黏膜暴露。手术后，患者康复。我们认为伤口感染和鼻窦炎同时出现的原因是酗酒、吸烟和上颌窦前壁黏膜暴露等多种因素。可吸收接骨板需要9个月至3年才能完全吸收，因此我们建议对有多种危险因素的患者进行至少3年的随访研究以确定其预后。
