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用于眼眶骨折修复的可吸收材料引起的炎性异物反应:一例报告。

Inflammatory foreign body reaction caused by resorbable materials used for orbital fractures repair: A case report.

作者信息

He Jie, Shi Wodong

机构信息

Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, People's Republic of China.

出版信息

Medicine (Baltimore). 2017 Dec;96(49):e8822. doi: 10.1097/MD.0000000000008822.

Abstract

RATIONALE

Resorbable materials have been recommended for orbital fractures repair. Many literatures reported the advantages of resorbable materials in clinical applications, but few reports about complications.

PATIENT CONCERNS

In this study, we encountered a 14-year-old boy treated for the orbital fracture by using resorbable plate, in whom inflammatory foreign body reaction was detected. In addition, this patient had repeated history of skin allergy and upper respiratory tract infection.

DIAGNOSES

Intraoperative observation showed that the resorbable material near the orbital rim was covered by granulation and inflammatory tissues, without purulent secretions. The histological examination revealed inflammatory foreign body reaction to the resorbable plate.

INTERVENTIONS

Debridement was taken to remove the mass on the left lower eyelid. At the outpatient examination, a small amount of granulation tissue was found at the incision. Then, secondary surgery for exploration and removal of the resorbable material was carried, 9 months after the first surgery.

OUTCOMES

One month after the surgery, the skin retraction, ectropion, and edema gradually improved.

LESSONS

Inadequate degradation of resorbable materials and patient's medical history of allergies may cause an inflammatory foreign body reaction. Therefore, it is prudent to choose resorbable materials for patients.

摘要

理论依据

可吸收材料已被推荐用于眼眶骨折修复。许多文献报道了可吸收材料在临床应用中的优势,但关于并发症的报道较少。

患者情况

在本研究中,我们遇到一名14岁男孩,他使用可吸收板治疗眼眶骨折,检测到有炎性异物反应。此外,该患者有反复的皮肤过敏和上呼吸道感染病史。

诊断

术中观察发现眼眶边缘附近的可吸收材料被肉芽组织和炎性组织覆盖,无脓性分泌物。组织学检查显示对可吸收板有炎性异物反应。

干预措施

进行清创以清除左下眼睑的肿块。门诊检查时,在切口处发现少量肉芽组织。然后,在首次手术后9个月进行二次手术,探查并取出可吸收材料。

结果

术后1个月,皮肤退缩、睑外翻和水肿逐渐改善。

经验教训

可吸收材料降解不完全以及患者的过敏病史可能会引起炎性异物反应。因此,为患者选择可吸收材料时应谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/5728858/a47becbc361c/medi-96-e8822-g001.jpg

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