Medpor Implant Fixation Using Fibrin Glue in the Treatment of Medial Orbital Wall Fracture

Abstract

The optimal treatment modalities are determined based on the symptoms and degree of the bone defects in patients with medial orbital wall blowout fracture. Most of the patients in this series underwent implant surgery. However, there are many patients whose implants were not fixed during surgery. Therefore, some patients who had implant migration occurred had been reported. We have therefore used methods for applying fibrin glue (Tisseel, Baxter Healthcare, Norfolk, United Kingdom) for the fixation of implant. Between 2007 and 2013, a total of 168 patients underwent porous polyethylene orbital implant (Medpor) surgery with the application of Tisseel. All the patients underwent surgical treatments via a transcaruncular approach, for which the Medpor was used. Postoperative complications include 6 cases of the limitation of extraoccular movement, 10 cases of diplopia, and 7 cases of enophthalmos. However, there were no specific complications caused by Tisseel. All the patients were satisfied with the treatment outcomes. In this study, we report the usefulness of Tisseel in the fixation of the medial orbital wall fracture using the Medpor implant with a review of literatures.

A prospective randomized study comparing fibrin sealant versus suture for conjunctival wound closure in orbital wall fracture surgery

“…Specifically, fibrin sealant reduces both the shear force between the tissues surrounding the surgical site and the risk of haemorrhage, thereby preventing postoperative swelling and ecchymosis. [15][16][17] A major drawback is that the use of fibrin sealant might theoretically be associated with disease transmission and/or anaphylactic reaction, although the authors are unaware of any such cases. 3 In this study, none of the patients developed an allergic reaction or viral infection during the follow-up period.…”

“…Several previous studies have reported that Medpor implant fixation with fibrin sealant is a faster, easier, and more secure method when compared with other fixation methods, such as wiring or drilling. 15,16 Anti-fibrinolytic components such as aprotinin allow the fibrin clot to maintain its structural integrity for approximately 3 weeks. During this period, the surrounding tissues can grow into the small holes of the Medpor while surgical wound healing occurs, thereby maintaining the stability of the reconstructed site.…”

Synergistic Voltaglue Adhesive Mechanisms with Alternating Electric Fields

“…The mechanical modulus was tuned within 0.5 Pa to 10 kPa values, which lie within the range observed for most soft tissues (0.1 Pa to 10 kPa). − This has implications for mimicking tissue compliance with synthetic biomaterials at the biomaterial interface. Adhesion to collagen ranges from 25 to 82 kPa, which is 1.2 times higher when compared to DC electric fields and 16-fold higher than commercially available fibrin glue (5 kPa). , Tunable adhesion and cohesive failure may be beneficial for wound-healing electrical treatments where low-risk wound trauma is desired during a change of dressings.…”

“…Adhesion to collagen ranges from 25 to 82 kPa, which is 1.2 times higher when compared to DC electric fields 1 and 16-fold higher than commercially available fibrin glue (5 kPa). 31,32 Tunable adhesion and cohesive failure may be beneficial for wound-healing electrical treatments where lowrisk wound trauma is desired during a change of dressings. The complete progression of electrocuring is achieved at much lower electric fields of ≤2 V/mm with respect to AC, whereas DC requires ≥5 V/mm (Figure S1, 150−180 V/30 mm).…”

Endoscopic endonasal repair with polyethylene implants in medial orbital wall fractures: A prospective study on 25 cases

“…One advantage of the technique presented here leans on the use of a polyethylene sheet. This has been widely used to repair the floor of the orbit and has proven reliable (Ram and Shadab, 2010;Kang et al, 2015). This material is strong enough while highly moldable (Lee et al, 2005).…”