Bioabsorbable struts made from poly-L-lactide and their application for treatment of chest deformity

Poly-L-lactide, a polymer of lactic acid, shows slow degradation in living tissue. Poly-L-lactide plate of high molecular weight maintains more than 90% of its initial mechanical properties for more than 3 months after implantation. Using struts made from poly-L-lactide plate, we performed chest wall reconstruction in 56 patients: for postoperative chronic sternal dehiscence in 23 and sternal elevation for pectus excavatum in 33 cases. The postoperative external appearances of the anterior chest were improved in comparison with the preoperative state in all cases. The internal features were evaluated by computed tomographic scan. Neither postoperative wound infection nor respiratory complication was observed, and no tendency for regression of the anterior chest occurred in any of the patients. In 3 of 56 cases (5.4%; one in the sternal dehiscence group and two in the pectus excavatum group), it was necessary to remove part of the strut because of overgrowth of granulation tissue around the implanted material after 4, 12, and 13 postoperative months, respectively. In the pectus excavatum group, the computed tomographic evaluations showed that poly-L-lactide strut maintained sufficient strength to support the thoracic wall 5 months after implantation. These findings suggest that the bioabsorbable poly-L-lactide strut is a promising material for surgical treatment of chest deformity.