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Page 6 of 17 Plast Aesthet Res 2018;5:6 I http://dx.doi.org/10.20517/2347-9264.2018.08

9. Alloplastic cranioplasty reconstruction: a systematic review comparing outcomes with
titanium mesh, polymethyl methacrylate, polyether ether ketone, and norion implants

Jeremie Oliver, Joseph Banuelos Mancilla, Krishna Vyas, Basel Sharaf

Mayo Clinic - MN

Aim: Alloplastic cranioplasty has evolved significantly over the years with the development of different
materials to serve as a medium of repair to the defect, such as titanium mesh (Ti), polymethyl methacrylate
(PMMA), polyether ether ketone (PEEK), and norion implants. There has yet to be published a systematic
review of such outcomes among the alloplastic materials we have compared in this study. Our objective
in this study was to compare postoperative rates of infection, local complications and allograft failures
following cranioplasty reconstruction using Ti, PMMA, PEEK, and norion implants.

Methods: Newcastle-Ottawa Quality Assessment Scale guidelines were used for article identification,
screening, eligibility and inclusion. The electronic literature search included Medline/Pubmed, Scopus and
Cochrane Database.

Results: Eighty-three studies and 5320 patients (mean age = 40.6 years) were included in our review (Ti = 2383,
PMMA = 2116, PEEK = 487, norion = 334). Overall, Ti was associated with the lowest post-operative infection
rate (4.91%, P = 0.0026, Pearson’s Exact Test) compared to all other sub-groups. PMMA implants were associated
with the highest infection rate (7.23%, P = 0.0021, Pearson’s Exact Test). Norion implants were associated with the
highest local complication rate (15.27%) but this was not statistically significant. PEEK implants were associated
with the highest graft failure rate (6.78%) although this was only slightly higher than other implant types and did
not show statistical significance.

Conclusion: This preliminary analysis begins to address the knowledge gap in determining the infection,
local surgical complication and failure rates in alloplastic cranioplasty procedures, although longer-term
and randomized trials are warranted to validate any association found in this study.

10. A single center retrospective evaluation of a surgical strategy to battle biofilm utilizing
absorbable antibiotic beads

Joseph Gorvetzian, Christopher Demas, Ryan Kunkel

University of New Mexico School of Medicine

Aim: The implications of surgical site infections are undeniable. Increasingly, biofilms are being recognized
as potent adversaries that promote wound infection, complicate healing, and resist attempts at treatment.
Targeted delivery of ultrahigh concentrations of antibiotics following wound debridement may present a
means of mitigating biofilm establishment while simultaneously minimizing the unsavory side effects of
high dose systemic antibiotics. This study aimed to present a case series evaluating an antibiotic bead-based
method for addressing these problematic wounds.

Methods: A retrospective analysis of 83 surgeries on 60 patients with high susceptibility to biofilm infection
utilizing a strategy of debridement and absorbable antibiotic-laden calcium sulfate bead placement was