Bioabsorbable System-Related Subcutaneous Swelling After Craniofacial Surgery.

Area of Science:

• Pediatric Surgery
• Biomaterials Science
• Craniofacial Surgery

Background:

• Bioabsorbable systems are widely used for pediatric cranioplasty.
• Subcutaneous swelling is a known complication of bioabsorbable osteosynthesis.
• The comparative incidence of swelling based on different bioabsorbable materials remains unclear.

Purpose of the Study:

• To compare the incidence of subcutaneous swelling associated with different bioabsorbable materials used in pediatric cranioplasty.
• To analyze the occurrence and resolution of subcutaneous swelling in patients undergoing craniosynostosis repair with resorbable systems.

Main Methods:

• Retrospective review of patients undergoing primary cranioplasty for craniosynostosis (2014-2018).
• Analysis of subcutaneous swelling incidences over a 12-month follow-up period.
• Systematic review of published English-language literature on bioabsorbable systems for craniosynostosis since 1995.

Main Results:

• Two common bioabsorbable material groups were identified: poly D-lactic acid/polyglycolic acid and poly D-/L-lactic acid.
• Poly D-lactic acid/polyglycolic acid systems showed 0%-4.2% swelling incidence (3-9 months follow-up).
• Poly D-/L-lactic acid systems showed 5%-16.7% swelling incidence (6-12 months follow-up); all resolved spontaneously.

Conclusions:

• Determining the definitively superior material for reducing swelling was challenging due to study variations.
• Subcutaneous swelling is an inherent risk with all investigated resorbable systems.
• Preoperative patient counseling and diligent follow-up are crucial for managing this complication.