RESUMO
BACKGROUND: Periprosthetic orbital haemorrhage is an uncommon complication of the alloplastic implants used in post-traumatic orbital floor repair. The small case series or individual reports provide no definite causative explanation for this delayed bleeding around silicone implants. It is likely that it is related to the disruption of fine capillaries within the pseudocapsule surrounding the implant, since the material does cause low-grade irritation with evidence of chronic inflammation. CASE REPORT: We report the case of a patient who developed a spontaneous periprosthetic bleeding 18 years' post-silicone sheet reconstruction of the orbital floor. RESULTS: Urgent removal of the implant insured prompt resolution of all symptoms and no further problem during the 2-year follow-up. CONCLUSION: This report emphasizes that periprosthetic orbital haemorrhage can occur years after the initial repair. Awareness of this rare complication allows for prompt diagnosis, decreasing the possibility of permanent damage of the orbital content. The removal of implant is necessary to relieve the symptoms and prevent potential infective complications.
Assuntos
Fixação Interna de Fraturas/instrumentação , Fraturas Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica/efeitos adversos , Próteses e Implantes/efeitos adversos , Hemorragia Retrobulbar/etiologia , Placas Ósseas , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Pessoa de Meia-Idade , Fraturas Orbitárias/diagnóstico por imagem , Procedimentos de Cirurgia Plástica/métodos , Reoperação/métodos , Hemorragia Retrobulbar/diagnóstico por imagem , Hemorragia Retrobulbar/cirurgia , Elastômeros de Silicone/farmacologia , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodos , Resultado do TratamentoRESUMO
The ideal standard of treatment of the infected sternotomy wound is early recognition, adequate debridement and repair with well vascularised tissue. We describe a new technique The Waist Coat Flap, which adheres to these principles, but does not require muscle or omentum and does not compromise their future use, if required.
