Evaluation and Management of Exposed High-density Porous Polyethylene Implants

Abstract

Numerous autogenous and alloplastic materials have been used for restoration of contour deformities of the face. Alloplastic materials have come into use to replace autogeneous bone grafts because bone grafts are associated with donor site morbidity, resorption and difficulty in shaping. Porous high-density polyethylene (HDPPE) is a commercial product which is nonallergenic, nonantigenic, noncarcinogenic and nonresorbable, highly stable and somewhat flexible. It has pores of 125-250 mum which enable tissue ingrowth resulting in firm attachment and integration of the implant to the surrounding tissues. In this study we aimed to evaluate the fate of the exposed implants and proposed a method to manage the exposed medpor implants. Twenty rats were used for this experimental study. Three phases involving the implantation, exposition, and the closure of the implants were held respectively. Closure was performed in two groups: 1) After perforating the exposed implants; 2) Without perforating the exposed implants. No serious complications were seen. Perforated exposed implants when covered with flaps rather than grafts could be covered. Exposed implants were not covered easily as indicated by the previous studies. This study demonstrates that early closure of perforated implants with flaps can give the best clinical results when exposed implants are covered in a short period after exposition so that the ingrown fibrous tissues are still intact. We believe that grafting of the exposed medpor implants cannot be effective either in early or late period. Perforating the exposed implants yield successful results as ingrowth of the tissues are enabled.

Argon plasma improves the tissue integration and angiogenesis of subcutaneous implants by modifying surface chemistry and topography

“…One main reason for the poor performance of synthetic materials is the poor integration and lack of angiogenesis with the surrounding subcutaneous tissue, which leads to a lack of anchorage and consequently infection and extrusion of the implant. [1][2][3] To improve the outcome of synthetic biomaterials, the substrate should aim to guide desired cell responses by mimicking the extracellular matrix (ECM). With the recent advancements in nanotechnology, nanocomposites offer substrates with a dimension that mimics the native ECM, improving their biocompatibility.…”

Additive Manufacturing of Multi‐Scale Porous Soft Tissue Implants That Encourage Vascularization and Tissue Ingrowth

“…Promoting tissue integration and blood vessel formation is imperative for implant longevity and infection prevention. [ 9–12 ] Identifying materials and surface modifications that improve implant biocompatibility is an active research area. [ 13–15 ] In the case of breast implants, 3D polyurethane open‐cell foam coatings were initially introduced as a means of encouraging tissue ingrowth and showed promise in significantly reducing rates of capsular contracture.…”

Use of porous high-density polyethylene grafts in open rhinoplasty: no infectious complication seen in spreader and dorsal grafts

“…Due to bone grafts’ natural proportionate, they may resorb and are difficult to shape. Auricle grafts are not considered an appropriate support as they are weak, thin and non-uniform [ 8 , 10 ].…”

“…Plastic surgeons and ENT specialists are always in need of a strong and safe support when dealing with sever nose deformities like deviated and saddle noses. Bone and cartilage grafts both are lacking, as bone grafts may resorb and cartilage grafts may return the deformity because of cartilage memory [ 3 , 8 ].…”