Berghaus, Alexander

Handrock, Michael

Mulch, Günther

Owens, Neal

English

Open Access LMU ( Ludwig-Maximilians-Univ. München)

Chapter 6-Flaps, Grafts, and Transplants I 303 Porous Polyethylene and Proplast: Their Behavior In a Bony Implant Bed Alexander Berghaus, Günther Mulch, and Michael Handrock (Berlin) Arch. Otorhinolaryngol. 240:115-123, June 1984 6-53 Porous high-density polyethylene (PHDPE) has been used to reconstruct cartilaginous structures and should also be suitable for bony structures. It was compared with Proplast in a study of guinea pigs having 7-mm defects made in the calotte and 5 x 2 x 2-mm defects in the lower jaw. The defects were filled with implants of corresponding size, and a subperiosteal implant was placed on the nasal dorsum. Fifty-five Proplast implants and 55 PHDPE implants were compared. The PHDPE implants stimulated new bone formation substantially bet-ter than did the Proplast ones. Ossification exceeded 50% in 14 of 19 PHDPE implants at 3 months, and 7 showed more than 75% ossification. No Proplast case showed more than 25% ossification even after 6 months. 304 / Plastic and Reconstructive Surgery Fig 6-22. (top)~~i*orous high-density polyethylene J months after implantation in the calotte. Bony encasement of the edge without loss of form. Close contact of the surfaces if, implant; b> bone). Hg 6-23. {bottom)—Proplast 3 months after implantation in the calotte: structural deterioration of the synthetic material (i, implant). The material appears in bone marrow cavities (x). Courtesy of Berghaus, Α., et a!.: Arch. Otorhinolaryngot 240:115-123, June 1984.) Bony ingrowth was more marked from the narrow side of the implant. Both ossification of pores and advancing tongue-shaped areas of bony tissue were involved in anchorage of both types of implant* Bony encase-ment of the edge of the defect with PHDPE implants at 3 months (Fig 6-22) contrasted with structural deterioration of Proplast (Fig 6-23). Porous polyethylene appears to be more stable than Proplast when used to fill bony defects in guinea pigs. Both materials are relatively safe as far as infection* Porous polyethylene has been used clinically to correct facial skull defects. Patients with defects of the forehead and eye socket have obtained subjectively and objectively satisfactory results. p. In the quest for nonautogenous materials that could save operative time and expense as well as save the patient morbidity from the donor site, porous high-density polyethylene seems to be worth careful clinical use and observa-tion. If found to be successful there may be an attractive application in the Chapter 6-Flaps9 Grafts, and Transplants I 305 multiple stages of reconstruction throughout the growth and maturation of chil-dren who have craniofacial anomalies that warrant surgery.—RJ.H. 

Porous polyethylene and Proplast: their behavior in a bony implant bed.

Universität München: Elektronischen Publikationen

Chapter 6-Flaps, Grafts, and Transplants I 303 
Porous Polyethylene and Proplast: Their Behavior In a Bony Implant Bed 
Alexander Berghaus, Günther Mulch, and Michael Handrock (Berlin) 
Arch. Otorhinolaryngol. 240:115-123, June 1984 6-53 
Porous high-density polyethylene (PHDPE) has been used to reconstruct 
cartilaginous structures and should also be suitable for bony structures. It 
was compared with Proplast in a study of guinea pigs having 7-mm defects 
made in the calotte and 5 x 2 x 2-mm defects in the lower jaw. The 
defects were filled with implants of corresponding size, and a subperiosteal 
implant was placed on the nasal dorsum. Fifty-five Proplast implants and 
55 PHDPE implants were compared. 
The PHDPE implants stimulated new bone formation substantially bet-
ter than did the Proplast ones. Ossification exceeded 50% in 14 of 19 
PHDPE implants at 3 months, and 7 showed more than 75% ossification. 
No Proplast case showed more than 25% ossification even after 6 months. 
304 / Plastic and Reconstructive Surgery 
Fig 6-22. (top)~~i*orous high-density polyethylene J months after implantation in the calotte. Bony 
encasement of the edge without loss of form. Close contact of the surfaces if, implant; b> bone). 
Hg 6-23. {bottom)—Proplast 3 months after implantation in the calotte: structural deterioration of 
the synthetic material (i, implant). The material appears in bone marrow cavities (x). 
Courtesy of Berghaus, Α., et a!.: Arch. Otorhinolaryngot 240:115-123, June 1984.) 
Bony ingrowth was more marked from the narrow side of the implant. 
Both ossification of pores and advancing tongue-shaped areas of bony 
tissue were involved in anchorage of both types of implant* Bony encase-
ment of the edge of the defect with PHDPE implants at 3 months (Fig 6-
22) contrasted with structural deterioration of Proplast (Fig 6-23). 
Porous polyethylene appears to be more stable than Proplast when used 
to fill bony defects in guinea pigs. Both materials are relatively safe as far 
as infection* Porous polyethylene has been used clinically to correct facial 
skull defects. Patients with defects of the forehead and eye socket have 
obtained subjectively and objectively satisfactory results. 
p. In the quest for nonautogenous materials that could save operative time and 
expense as well as save the patient morbidity from the donor site, porous 
high-density polyethylene seems to be worth careful clinical use and observa-
tion. If found to be successful there may be an attractive application in the 
Chapter 6-Flaps9 Grafts, and Transplants I 305 
multiple stages of reconstruction throughout the growth and maturation of chil-
dren who have craniofacial anomalies that warrant surgery.—RJ.H. 


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Porous polyethylene and Proplast: their behavior in a bony implant bed.

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