Absorbable sutures for the achievement of stable osteosynthesis in surgery for craniosynostosis
Abstract
Aim of the study. The goal of the present study was to analyse the exclusive use of absorbable suture material (Vicryl) in the fixation of transposed bone segments in cranial vault reshaping without modification of the osteotomy design.
Clinical rationale for the study. In the surgical correction of craniosynostosis, bone fixation using osteosynthesis is a key step. Absorbable osteosynthesis is a widespread tool in cranial vault remodelling, but only a limited number of studies have described the use of absorbable sutures in the treatment of patients with craniosynostosis.
Materials and methods. In 72 children with various types of craniosynostosis, up to 24 months of age, osteosynthesis was conducted exclusively with Vicryl sutures. All patients were evaluated for the stability of postoperative results, and foreign body reactions were examined as part of the routine clinical and radiological follow-up ranging from 1 to 36 months.
Results. All examined children exhibited stable postoperative conditions with immediate stability of all remodelled cranial vaults. 2D and 3D radiological examinations demonstrated good bony union in all cases. Significant foreign body reactions were not observed and bone healing was noted at all sites.
Conclusion and clinical implications. The exclusive application of absorbable suture material enables stable and cost-effective osteosynthesis in craniofacial surgery without altering the osteotomy design.
Keywords: craniosynostosiscraniofacial surgeryosteosynthesisabsorbable suturescranial vault reconstruction
References
- Striker MV, Raphael B, Mazzola R. Craniofacial malformations. 1st ed. Churchill Livingstone, Edinburgh 1990: chapter 7.
- Whitaker LA, Bartlett SP, Schut L, et al. Craniosynostosis: an analysis of the timing, treatment, and complications in 164 consecutive patients. Plast Reconstr Surg. 1987; 80(2): 195–212.
- Tharanon W, Sinn DP, Hobar PC, et al. Surgical outcomes using bioabsorbable plating systems in pediatric craniofacial surgery. J Craniofac Surg. 1998; 9(5): 441–4; discussion 445.
- Barone CM, Jimenez DF. Special considerations in pediatric cranial fixation: a technical overview. J Craniomaxillofac Trauma. 1996; 2(4): 42–47.
- Yaremchuk MJ. Experimental studies addressing rigid fixation in craniofacial surgery. Clin Plast Surg. 1994; 21(4): 517–524.
- Fearon J. Rigid Fixation of the Calvaria in Craniosynostosis without Using “Rigid” Fixation. Plastic and Reconstructive Surgery. 2003; 111(1): 27–38.
- Ohata K, Haque M, Tsuruno T, et al. Craniotomy repair with titanium miniplates. J Clin Neurosci. 1998; 5(1): 81–86.
- Goldberg DS, Bartlett S, Yu JC, et al. Critical review of microfixation in pediatric craniofacial surgery. J Craniofac Surg. 1995; 6(4): 301–7; discussion 308.
- Obwegeser JA. [Absorbable and bioconvertible osteosynthesis materials in maxillofacial surgery]. Mund Kiefer Gesichtschir. 1998; 2(6): 288–308.
- Kumar CR, Sood S, Ham S. Complications of bioresorbable fixation systems in pediatric neurosurgery. Childs Nerv Syst. 2005; 21(3): 205–210.
- Losken A, Williams J, Burstein F, et al. Outcome Analysis for Correction of Single Suture Craniosynostosis Using Resorbable Fixation. Journal of Craniofacial Surgery. 2001; 12(5): 451–455.
- Pietrzak WS, Verstynen ML, Sarver DR. Bioabsorbable fixation devices: status for the craniomaxillofacial surgeon. J Craniofac Surg. 1997; 8(2): 92–96.
- Eppley BL, Li M. Long-spanning resorbable plates in cranial vault reconstruction. J Craniofac Surg. 2003; 14(1): 89–91.
- Pagnoni M, Fadda MT, Spalice A, et al. Surgical timing of craniosynostosis: what to do and when. J Craniomaxillofac Surg. 2014; 42(5): 513–519.
- Sauerhammer TM, Seruya M, Basci D, et al. Endocortical plating of the bandeau during fronto-orbital advancement provides safe and effective osseous stabilization. J Craniofac Surg. 2014; 25(4): 1341–1345.
- Duke BJ, Mouchantat RA, Ketch LL, et al. Transcranial migration of microfixation plates and screws. Case report. Pediatr Neurosurg. 1996; 25(1): 31–4; discussion 35.
- Freudlsperger C, Castrillon-Oberndorfer G, Baechli H, et al. The value of ultrasound-assisted pinned resorbable osteosynthesis for cranial vault remodelling in craniosynostosis. J Craniomaxillofac Surg. 2014; 42(5): 503–507.
- Eckelt U, Nitsche M, Müller A, et al. Ultrasound aided pin fixation of biodegradable osteosynthetic materials in cranioplasty for infants with craniosynostosis. J Craniomaxillofac Surg. 2007; 35(4-5): 218–221.
- Kosaka M, Miyanohara T, Wada Y, et al. Intracranial migration of fixation wires following correction of craniosynostosis in an infant. J Craniomaxillofac Surg. 2003; 31(1): 15–19.
- Wood RJ, Petronio JA, Graupman PC, et al. New resorbable plate and screw system in pediatric craniofacial surgery. J Craniofac Surg. 2012; 23(3): 845–849.
- Montag ME, Morales L, Daane S. Bioabsorbables: their use in pediatric craniofacial surgery. J Craniofac Surg. 1997; 8(2): 100–102.
