Porous high-density polyethylene for orbital reconstruction.

OBJECTIVE To determine the safety and efficacy of using porous high-density polyethylene (PHDPE) in the repair of orbital defects. DESIGN Retrospective case series. SETTING Academic tertiary care trauma center. Patients One hundred seventy patients with orbital defects requiring surgical repair. Intervention Orbital defect repair with PHDPE. Main Outcome Measure Our review documents surgical results and complications associated with the use of PHDPE. RESULTS There was a 6.4% complication rate associated with the use of PHDPE. The infection rate was 1.8%. The persistent orbital malposition rate was 3.5%. The extrusion rate was 0%. CONCLUSIONS This report represents the largest case series in the literature using PHDPE for orbital reconstructions. The use of PHDPE resulted in a low complication rate and excellent functional and cosmetic reconstructive results. Because of our success with the use of PHDPE, we have changed our clinical practice to minimize the use of autologous graft material, thereby eliminating donor site morbidity in cases involving orbital reconstruction.

[1]  Kun Hwang,et al.  Alloplastic Template Fixation of Blow-Out Fracture , 2002, The Journal of craniofacial surgery.

[2]  J. Thomas,et al.  Clinical and histologic response of subcutaneous expanded polytetrafluoroethylene (Gore-Tex) and porous high-density polyethylene (Medpor) implants to acute and early infection. , 1997, Archives of otolaryngology--head & neck surgery.

[3]  J. Shore,et al.  Porous polyethylene channel implants: a modified porous polyethylene sheet implant designed for repairs of large and complex orbital wall fractures. , 1999, Ophthalmic plastic and reconstructive surgery.

[4]  P. Rubin,et al.  Orbital reconstruction using porous polyethylene sheets. , 1994, Ophthalmology.

[5]  T. Wellisz.  Clinical experience with the medpor porous polyethylene implant , 2004, Aesthetic Plastic Surgery.

[6]  R. Haug,et al.  A comparison of microscrew and suture fixation for porous high-density polyethylene orbital floor implants. , 1993, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[7]  S. Mccormick,et al.  Modulation of tissue ingrowth into porous high-density polyethylene implants with basic fibroblast growth factor and autologous blood clot. , 2000, Archives of facial plastic surgery.

[8]  S. Lee,et al.  The use of high-density polyethylene implants in facial deformities. , 1998, Archives of otolaryngology--head & neck surgery.

[9]  W. Zimmerli,et al.  Pathogenesis of foreign body infection: description and characteristics of an animal model. , 1982, The Journal of infectious diseases.

[10]  J. Patrinely,et al.  Growth Factors Embedded in an Agarose Matrix Enhance the Rate of Porous Polyethylene Implant Biointegration , 2000, Ophthalmic plastic and reconstructive surgery.

[11]  G. Cosnard,et al.  Postcontrast magnetic resonance imaging assessment of porous polyethylene orbital implant (Medpor). , 2000, Ophthalmology.

[12]  J. Kreidler,et al.  Endoscopic findings of maxillary sinus after middle face fractures , 1975 .

[13]  M. Yaremchuk,et al.  Facial Skeletal Reconstruction Using Porous Polyethylene Implants , 2003, Plastic and reconstructive surgery.

[14]  P. Manson,et al.  Use of Medpor porous polyethylene implants in 140 patients with facial fractures. , 1993, The Journal of craniofacial surgery.

[15]  G. Granström,et al.  A prospective study of orbital fracture sequelae after change of surgical routines. , 2003, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  A. Maloof,et al.  Medpor porous polyethylene implants in orbital blowout fracture repair , 2001, Eye.

[17]  M. Yaremchuk,et al.  Porous polyethylene implant for orbital wall reconstruction. , 1995, The Journal of cranio-maxillofacial trauma.

[18]  J. Patrinely,et al.  Epidermal and Fibroblast Growth Factors Enhance Fibrovascular Integration of Porous Polyethylene Implants , 2000, Ophthalmic plastic and reconstructive surgery.

[19]  R. James,et al.  Induction of staphylococcal infections in mice with small inocula introduced on sutures. , 1961, British journal of experimental pathology.

[20]  Jacobsen Jb,et al.  The use of Gore-Tex implants in nasal augmentation operations. , 1989 .

[21]  Yu-Ray Chen,et al.  Endoscopically Assisted Repair of Orbital Floor Fractures , 2001, Plastic and reconstructive surgery.

[22]  L. Lin,et al.  Porous polyethylene implants in orbital floor reconstruction. , 2007, Journal of the Formosan Medical Association = Taiwan yi zhi.