Outcomes and complications based on experience with resorbable plates in pediatric craniosynostosis patients

The structure and functional relationship of polymers have long been the purview of engineers and polymer chemists. Bioabsorbable fixation devices have been used for decades as dissolvable suture meshes and, recently, routinely by orthopedic surgeons. During the past decade, bioabsorbable fixation systems have become available for use by craniomaxillofacial surgeons for cranial vault remodeling. This study evaluates the application of a bioabsorbable fixation system in reconstructive craniofacial procedures in a pediatric population. We reviewed 146 cases of cranial vault reconstruction including 98 boys and 48 girls ranging from 2 months to 16 years (mean, 15 months) in age. The procedures were performed for 6 years between January 1998 and June 2004. Bioabsorbable plates and screws were used in each case; most of these cases were craniosynostosis reconstructions. There were 69 cases of frontal sagittal craniosynostosis, 36 metopic, 20 unicoronal, 12 bicoronal, 5 lamboid, 2 deformational plagiocephaly, and 2 multiple fusion of sutures. Postoperative evaluation consisted of clinical examination and three-dimensional computed tomography scan reconstructions at 3, 6, and 12 months. Items specifically screened for on the clinical examination included wound healing, signs of infection, and palpability of implant through the skin. Six patients had palpable plates, 2 patients had palpable screw, and 5 patients had infection at the incision site (of which only 3 were treated with inpatient care including incision drainage and intravenous antibiotics). Our experience has been overwhelmingly positive, and we feel that our results suggest that resorbable fixation is a superior option in pediatric plastic and craniofacial surgery.