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Solvent-dehydrated calvarial allografts in craniofacial surgery.
- Source :
-
Plastic and reconstructive surgery [Plast Reconstr Surg] 2004 Aug; Vol. 114 (2), pp. 298-306. - Publication Year :
- 2004
-
Abstract
- Craniofacial surgery almost always requires the use of bone grafting. Although autografts are the standard procedure for bone grafting, it is sometimes not possible to harvest bone, and autografts have particular risks. The use of allograft bone provides a reasonable alternative to meet the need for graft material. Solvent dehydration is a multistage procedure in which human cadaveric bone is processed by osmotic exchange baths and gamma sterilization. This processing avoids the risk of infection transmission, decreases antigenicity, and does not weaken the mechanical properties of the bone. Solvent-dehydrated, gamma-irradiated human calvarial bone allografts were used for reconstruction of craniofacial deformities in 24 patients between 1988 and 2002. Resorption of the allografts and results of the surgical intervention were evaluated with plain radiographs and three-dimensional computed tomography 12 months after surgery, in 21 patients. Serologic tests for human immunodeficiency virus-1 antibody, hepatitis B surface antigen, and hepatitis C antigen were also performed. Biopsy specimens were taken from the allografts. Average follow-up in this group was 30 months (range, 8 to 60 months), and results of serologic tests were negative in all patients. Seventy-one percent of the patients (15 of 21) showed no resorption, with partial and complete allograft fusion. One patient had nearly total graft loss and the remaining five patients had 10 to 25 percent graft resorption. Rigid fixation of the allograft, contact with the dura and periosteum, and prevention of dead spaces around the allograft are the most important factors in achieving a satisfactory result. In solvent-dehydrated bone allografts, sterilization and antigenic tissue cleaning are achieved after several steps with a minimal dose of radiation. The result is a nonantigenic, sterile mechanical scaffold that can tolerate external forces. Although autografts are the standard in craniofacial surgery, solvent-dehydrated calvarial bone allografts produced successful results in selected cases.
- Subjects :
- Adolescent
Adult
Bone Regeneration physiology
Bone Resorption diagnostic imaging
Bone Resorption pathology
Child
Child, Preschool
Craniofacial Abnormalities diagnostic imaging
Craniofacial Abnormalities pathology
Desiccation
Female
Follow-Up Studies
Gamma Rays
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Infant
Male
Middle Aged
Osseointegration physiology
Postoperative Complications diagnostic imaging
Postoperative Complications pathology
Sterilization methods
Tissue Donors
Tomography, X-Ray Computed
Transplantation, Homologous
Bone Transplantation
Craniofacial Abnormalities surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0032-1052
- Volume :
- 114
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Plastic and reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 15277792
- Full Text :
- https://doi.org/10.1097/01.prs.0000131983.48201.e2