Oraby, M., Sharara, A., Fahmy, M. (2015). CLINICAL EVALUATION OF THE USE OF PROCEED ®MESH IN RECONSTRUCTION OF ORBITAL FLOOR FRACTURES: CLINICAL TRIAL. Alexandria Dental Journal, 40(1), 8-14. doi: 10.21608/adjalexu.2015.59118
M.S Oraby; A.A Sharara; M.H Fahmy. "CLINICAL EVALUATION OF THE USE OF PROCEED ®MESH IN RECONSTRUCTION OF ORBITAL FLOOR FRACTURES: CLINICAL TRIAL". Alexandria Dental Journal, 40, 1, 2015, 8-14. doi: 10.21608/adjalexu.2015.59118
Oraby, M., Sharara, A., Fahmy, M. (2015). 'CLINICAL EVALUATION OF THE USE OF PROCEED ®MESH IN RECONSTRUCTION OF ORBITAL FLOOR FRACTURES: CLINICAL TRIAL', Alexandria Dental Journal, 40(1), pp. 8-14. doi: 10.21608/adjalexu.2015.59118
Oraby, M., Sharara, A., Fahmy, M. CLINICAL EVALUATION OF THE USE OF PROCEED ®MESH IN RECONSTRUCTION OF ORBITAL FLOOR FRACTURES: CLINICAL TRIAL. Alexandria Dental Journal, 2015; 40(1): 8-14. doi: 10.21608/adjalexu.2015.59118
CLINICAL EVALUATION OF THE USE OF PROCEED ®MESH IN RECONSTRUCTION OF ORBITAL FLOOR FRACTURES: CLINICAL TRIAL
Instructor at Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University.
Abstract
Introduction: Orbital fracture is a common type of midfacial trauma. Its proper treatment is considered a challenging situation. Otherwise orbital complications; as diplopia, limited ocular motility, enophthalmos, hypoglobus and infraorbital dysesthesia; may occur. Proceed® mesh consists of polypropylene soft mesh encapsulated with polydioxanone (PDS) and layered with oxidized regenerated cellulose (ORC). It is a widely used mesh in hernia repair which is proved to be safe and suitable. The ORC component provides the mesh with some properties differ from other materials. It provides a physical barrier to decrease the adhesion between the mesh and orbital tissue. It is a commonly used hemostatic agent. In addition, it is proved to be antibacterial against many resistant species. The PDS component attaches the ORC with polypropylene soft mesh. Objectives: We aimed in this study to evaluate Proceed® mesh clinically in reconstruction of orbital floor defects in seven patients. Materials and Methods: Indications for intervention were diplopia, enophthalmos, minimal clinical improvement over time under drug therapy, ocular limited motility, dystopia, defect more than 50% of the orbital floor and progressive infraorbital hypoesthesia. The ORC side of the mesh was placed facing orbital soft tissue, while polypropylene side was placed towards orbital bony wall. The follow-up schedule was 3 days postoperatively then once weekly for two weeks and then monthly for 6 months. Results: Clinically, most patients recovered from diplopia, dystopia, ocular restriction and enophthalmos. Two patients had transitory postoperative diplopia (for 1 week), that may be due to postoperative muscle weakness. One patient out of four suffered from preoperative ocular restriction, had no or slight improvement postoperatively. Two patients complained from inflammatory reaction within 2-4 weeks postoperatively, resolved by anti-inflammatory and antibiotic administration. Conclusion: The study concluded that Proceed® mesh is a suitable material for orbital floor reconstruction, especially in cases of small to medium defects (< 3 cm2).
1. Natu SS, Pradhan H, Gupta H, Alam S, Mohammad S, Pradhan R, et al. An epidemiological study on pattern and incidence of mandibular fractures. Plast Surg Int 2012; 2012: 834364.
2. Reyes JM, Vargas MFG, Rosenvasser J, Arocena MA, Medina AJ, Funes J. Classification and epidemiology of orbital fractures diagnosed by computed tomography. Rev Argent Radiol 2013; 77:139-46.
3. Michael B. Salin BMS. Diagnosis and treatment of midface fractures. In: Fonseca WR (ed). Oral and Maxillofacial Trauma. 3rd ed. Ch 21. Elsevier, 2005. p. 671-2.
4. Baino F. Biomaterials and implants for orbital floor repair. Acta biomaterialia 2011;7:3248-66.
5. Scherer M, Sullivan WG, Smith DJ Jr, Phillips LG, Robson MC. An analysis of 1,423 facial fractures in 788 patients at an urban trauma center. J Trauma 1989; 29: 388-90.
6. Piombino P, Iaconetta G, Ciccarelli R, Romeo A, Spinzia A, Califano L. Repair of orbital floor fractures: our experience and new technical findings. Craniomaxillofac Trauma Reconstr 2010; 3: 217-22.
7. Tang DT, Lalonde JF, Lalonde DH. Delayed immediate surgery for orbital floor fractures: Less can be more. Can J Plast surg 2011; 19: 125-8.
8. Folkestad, Lena. Orbital floor fractures- aspects of diagnostic methods, treatment and sequelae. P.h.D Thesis. Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg University. 2006.
9. Avashia YJ, Sastry A, Fan KL, Mir HS, Thaller SR. Materials used for reconstruction after orbital floor fracture. J Craniofac Surg 2012; 23:1991-7.
10. Schendel SA. The Orbit, An Issue of Oral and Maxillofacial Surgery Clinics. 1st ed. London: Elsevier Health Sciences, 2012.
11. Bhatnagar S, Khare P. Reconstruction of orbital floor fracture using porous polyethylene mesh.Int J Med Res Rev 2014; 2: 1.
12. Shetty P, Senthil Kumar G, Baliga M, Uppal N. Options in orbital floor reconstruction in blowout fractures: a review of ten cases. J Maxillofac Oral Surg 2009; 8: 137-40.
13. Thorne CH, Gurtner GC. Grabb and Smith's plastic surgery: Lippincott Williams & Wilkins, 2013.
14. Spangler D, Rothenburger S, Nguyen K, Jampani H, Weiss S, Bhende S. In vitro antimicrobial activity of oxidized regenerated cellulose against antibiotic-resistant microorganisms. Surg Infect 2003; 4: 255-62.
15. Ethicon. SURGICEL® Family of Absorbable Hemostats ETHICON 360 [Internet].Available at: http://www.ethicon360.com/products/surgicelfamily-absorbable-hemostats.
16. Mok D, Lessard L, Cordoba C, Harris PG, Nikolis A. A review of materials currently used in orbital floor reconstruction.Can J Plast Surg. 2004; 12:134.
17. Burnstine MA. Clinical recommendations for repair of isolated orbital floor fractures.Ophthalmology 2002; 109:1207-10.
18. Rosenberg J, Burcharth J. Feasibility and outcome after laparoscopic ventral hernia repair using Proceed mesh. Hernia. 2008; 12:453-6.
19. Eltayeb AA, Ibrahim IA, Mohamed MB. The use of PROCEED mesh in ventral hernias: A pilot study on 22 cases. Afr J Paediatr Surg 2013; 10:217.
20. Doctor HG. Evaluation of various prosthetic materials and newer meshes for hernia repairs.J Minim Access Surg 2006; 2:110-6.
21. Deeken CR, Abdo MS, Frisella MM, Matthews BD. Physicomechanical evaluation of absorbable and nonabsorbable barrier composite meshes for laparoscopic ventral hernia repair. Surg Endosc 2011; 25:1541-52.
22. Rubin JP, Yaremchuk MJ. Complications and toxicities of implantable biomaterials used in facial reconstructive and aesthetic surgery: a comprehensive review of the literature. Plast Reconstr Surg. 1997; 100:1336-53.
23. Conze J, Kingsnorth AN, Flament JB, Simmermacher R, Arlt G, Langer C, et al. Randomized clinical trial comparing lightweight composite mesh with polyester or polypropylene mesh for incisional hernia repair. Br J Surg 2005; 92:1488-93.
24. Rubin PA, Popham JK, Bilyk JR, Shore JW. Comparison of fibrovascular ingrowth into hydroxyapatite and porous polyethylene orbital implants. Ophthal Plast Reconstr Surg.1994; 10:96- 103.
25. Nicholson DH, Guzak SV, Jr. VIsual loss complicating repair of orbital floor fractures.Archives of Ophthalmology. 1971; 86:369-75.
26. Brown AE, Banks P. Late extrusion of alloplastic orbital floor implants. British Journal of Oral and Maxillofacial Surgery. 1993; 31:154-7.
27. Davis RM. Late orbital implant migration. Ann Ophthalmol. 1986 ;18:223-4.
28. Dougherty WR, Wellisz T. The natural history of alloplastic implants in orbital floor reconstruction: an animal model. J Craniofac Surg. 1994 ;5:26-32.
29. Dineen P. The effect of oxidized regenerated cellulose on experimental infected splenotomies. J Surg Res 1977; 23:114-6.
30. Nguyen P.N. SP. Advances in the management of orbital fractures. Clin Plast Surg 1992;19:87-98
31. Nunery WR, Tao JP, Johl S. Nylon foil "wraparound" repair of combined orbital floor and medial wall fractures. Ophthal Plast Reconstr Surg 2008; 24:271-5
32. Harrell AG, Novitsky YW, Peindl RD, Cobb WS, Austin CE, Cristiano JA, et al.Prospective evaluation of adhesion formation and shrinkage of intra-abdominal prosthetics in a rabbit model. Am Surg. 2006; 72:808-13.
33. Lee HBH, Nunery WR. Orbital Adherence Syndrome Secondary to Titanium ImplantMaterial. Ophthal Plast Reconstr Surg 2009; 25:33-6.
34. Rubin P, Bilyk J, Shore J. Management of orbital trauma: fractures, hemorrhage, and traumatic optic neuropathy. Am Acad Ophthalmol Focal Points 1994; 7:1-8.
36. Choi JC, Bstandig S, Iwamoto MA, Rubin PA, Shore JW. Porous polyethylene sheet implant with a barrier surface: a rabbit study. Ophthal Plast Reconstr Surg. 1998; 14:32-6.
37. Janecka IP. New reconstructive technologies in skull base surgery: role of titanium mesh and porous polyethylene. Archives of otolaryngology-- head & neck surgery. 2000
38. Mar;126:396-401.Bilyk JR, Rubin PAD, Shore JW. Correction of Enophthalmos with Porous Polyethylene Implants. Int Ophthalmol Clin 1992; 32:151-6.
39. Mauriello JA, Jr., Wasserman B, Kraut R. Use of Vicryl (polyglactin-910) mesh implant for repair of orbital floor fracture causing diplopia: a study of 28 patients over 5 years. Ophthal Plast Reconstr Surg. 1993;9:191-5.
40. Aramayo ALG, Lopes Filho GdJ, Barbosa CdA, Amaral VdF, Costa LA. Abdominal wall healing in incisional hernia using different biomaterials in rabbits. Acta Cir Bras2013;28:307-16.
View on SCiNiTO
Top