Martin Kauke-Navarro, Leonard Knoedler, Helena Baecher, Khalil Sherwani, Samuel Knoedler, Omar Allam, Fortunay Diatta, Michael Alperovich, Ali-Farid Safi
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引用次数: 0
Abstract
Background: Assessing facial plastic surgery techniques is essential for improving patient safety and outcomes through evidence-based practices. Despite the extensive use of facial implants, there is a scarcity of thorough research on their long-term effects and safety profiles.
Methods: A systematic review was conducted following PRISMA guidelines, analyzing studies from 1970 to 2024 on various implant materials for facial reconstruction and augmentation. The databases searched for this review included PubMed, Web of Science, Google Scholar, and EMBASE. Inclusion criteria were full-text articles in English, focusing on alloplastic materials for craniofacial skeleton replacement or augmentation.
Results: We included 117 studies with 4,273 patients and a mean follow-up of 34 months (range: 15 days to 25 years). Of these, 56% focused on reconstruction, 33% on aesthetics, and 10% on both. Patient ages ranged from 6 months to 85 years, with most studies addressing the orbital (29%), chin (22%), and malar (19%) regions. 67% of studies evaluated potential complications and found an overall rate of 4.4%. Nerve injuries (2.1%) and infections (1.0%) were the most frequent issues, with hematoma, implant displacement, and bone resorption rates at 1.4%, 0.59%, and 0.68%, respectively. Patient-specific implants (PSIs) showed promise in reducing complications such as infections, suggesting that customization to patient anatomy may provide benefits. The highest rate of complication-free postoperative recovery was observed with polyethylene facial implants.
Conclusion: This review highlights variability in implant performance. The increased use of PSI suggests improved outcomes, warranting further investigation. Standardized outcome reporting and further research are needed to enhance comparability and guide clinical practice.
背景：评估面部整形手术技术对于通过循证实践提高患者安全性和预后至关重要。尽管面部植入物被广泛使用，但缺乏对其长期效果和安全性的深入研究。方法：根据PRISMA指南进行系统回顾，分析1970年至2024年各种面部重建和隆胸种植材料的研究。检索的数据库包括PubMed、Web of Science、b谷歌Scholar和EMBASE。纳入标准为英文全文文章，重点是颅面骨骼置换或增强的同种异体材料。结果：我们纳入117项研究，4273例患者，平均随访34个月（15天至25年）。其中56%的人关注重建，33%的人关注美学，10%的人两者都关注。患者年龄从6个月到85岁不等，大多数研究针对眼眶（29%）、下巴（22%）和颧（19%）区域。67%的研究评估了潜在的并发症，发现总体发生率为4.4%。神经损伤（2.1%）和感染（1.0%）是最常见的问题，血肿、种植体移位和骨吸收率分别为1.4%、0.59%和0.68%。患者特异性植入物（psi）有望减少感染等并发症，这表明根据患者解剖结构定制可能会带来好处。聚乙烯面部种植体的术后无并发症恢复率最高。结论：本综述强调了种植体性能的可变性。PSI使用的增加表明结果有所改善，值得进一步调查。需要标准化的结果报告和进一步的研究来增强可比性和指导临床实践。系统评价注册：PROSPERO，标识符（CRD42024501754）。
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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