Complications Associated With Polycaprolactone (PCL) Use in Septorhinoplasty: A Systematic Review and Meta-Analysis

To evaluate the complications associated with polycaprolactone (PCL) use in septorhinoplasty.

OVID EMBASE, OVID MEDLINE, SCOPUS, and PubMed.

Studies reporting complications related to PCL in septorhinoplasty were included. Primary outcomes encompassed complications including tip deformity/warping, stiffness, deviation, infection, protrusion/extrusion, skin complications, epistaxis, and revision/reoperation. Subgroup analyses were conducted based on the type of operation, approach, surgery, graft, and material used.

A total of 13 studies, including 1194 patients, were analyzed. The pooled mean proportion of complications was relatively low, ranging from 0% to 0.72% (deviation 0% [95% CI -0.00 to 0.01], skin complications 0% [95% CI -0.00 to 0.00], infection 0.01% [95% CI 0.00-0.01], protrusion/extrusion 0.01% [95% CI 0.00-0.01], tip decrease/warping 0.02% [95% CI -0.00 to 0.04], revision/reoperation 0.03% [95% CI 0.02-0.03], epistaxis 0.07% [95% CI -0.06 to 0.21], and stiffness 0.72% [95% CI 0.59-0.85]). Subgroup analyses showed no statistically significant differences in complication based on operation type or graft type for tip decrease/warping (P = .70, P = .54), deviation (P = .16, P = .37), infection (P = .26, P = .68), protrusion/extrusion (P = .25, P = .73), skin complications (P = .25 for graft type), and revision/reoperation (P = .97, P = .99). Subgroup analysis by type of surgical approach (open, endonasal), type of procedure (primary, revision), and type of material (PCL, PCL combined with cartilage) could not be performed due to limitations in the original data.

PCL appears to demonstrate acceptable short- to mid-term safety in septorhinoplasty. However, long-term and comparative data are needed to better define its role.