First Bioabsorbable Fixation System in Craniofacial Surgery on the 15th Anniversary of Its US Utility

Safety of Contemporary Resorbable Fixation Systems for Craniofacial Reconstruction in Pediatric Patients

BACKGROUND

Resorbable hardware allows adequate strength for maintaining the relative position of the craniofacial skeleton during osseous healing, and allowing subsequent growth in pediatric patients. The purpose of this study was to determine the complication profile of the latest copolymer of resorbable plates for craniofacial reconstruction in pediatric patients.

METHODS

Retrospective query of the operative billing record was performed for use of the DePuy Synthes Rapidsorb Fixation System at the authors' tertiary children's hospital from 2015 to 2019. Three hundred twenty-five patients were randomly selected for analysis of complications within the first postoperative year.

RESULTS

Median age at craniofacial reconstruction was 3.0 years, with 127 procedures (39.9 percent) performed for an intracranial mass and 141 procedures (44.3 percent) performed for craniosynostosis. Overall, 7.9 percent patients had a postoperative wound complication. The most common complications were dehiscence (3.8 percent), hematoma/seroma (3.5 percent), and infection (2.5 percent). There were no instances of extrusion, plate fracture, or screw loosening. Hardware complications in the temporoparietal region were more likely to occur at incision sites (p = 0.001), whereas wound complications at the frontal region were more likely to occur away from incision sites (p < 0.001). There were no differences in complications between plates secured with resorbable screws or with the resorbable injectable polymer system (p ≥ 0.161 for all). Radiotherapy was significantly implicated in development of clinical infection (p = 0.001), culture-positive infection (p < 0.001), readmission (p = 0.007), reoperation (p = 0.003), and plate removal (p = 0.007).

CONCLUSION

Resorbable cranial hardware has an overall favorable complication profile for craniofacial reconstruction in pediatric patients undergoing surgical intervention for craniosynostosis or intracranial mass resection.

Improving the quality of life of patients through pediatric plastic and craniofacial surgery

Pediatric plastic surgery, as a super specialty of plastic surgery, is done on children with deformities that are congenital or acquired, with the major thrust of improving the quality of life of the children for the many years to come throughout their long lives. Although the focus on appearance is most often done to make the children appear as near normal as possible, physical growth and development as well as function should be included in the focus, based on the principles of a sound plastic surgery. In this short space, we categorize 3 examples of deformity as congenital, traumatic, and oncologic. We will include many aspects of each, but not all. We will focus on interesting and common clinical problems. The goal of the work that is done on the children is not procedure oriented but rather principle derived.