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Appl. Sci. 2017, 7(3), 276; doi:10.3390/app7030276

Cranioplasty and Craniofacial Reconstruction: A Review of Implant Material, Manufacturing Method and Infection Risk

1
Faculty of Engineering and IT, The University of Sydney, Sydney NSW 2006, Australia
2
Sydney Medical School, The University of Sydney, Sydney NSW 2006, Australia
3
Sydney Spine Institute; Sydney NSW 1805, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Daniel X.B. Chen
Received: 30 November 2016 / Accepted: 6 March 2017 / Published: 10 March 2017
(This article belongs to the Special Issue Bio-Inspired Applications of Composites)
View Full-Text   |   Download PDF [661 KB, uploaded 14 March 2017]   |  

Abstract

Analysis of current literature highlights a wide variation in reported infection risk for different materials in cranial repair. The purpose of these composite materials are to mimic natural bone and assist in restoring function (structurally and aesthetically) to the human skull. This review aims to examine the meta-data in order to provide an amalgamated overview of potential trends between implant material, manufacturing method and infection risk, in order to provide a core reference point for future studies surrounding emerging biomedical materials in the fields of cranioplasty by providing base point for understanding the capabilities and limitations of current technologies. Methods: A search for articles was conducted, with the following criteria seen as fundamental in providing an accurate picture of the current landscape: publication in the last decade, provision of a numerical value for both number of implants and infection cases, patient sample of 10+, adult patients, and cranioplasty/cranial repair. Results: A total of 41 articles were seen to meet the author’s inclusion criteria. Average infection rates per material ranged between 2.04% and 10.98%. The results indicate that there is variation between materials in regards to total infection risk, however, depending on the materials compared, this value may be insignificant. Alternative risk factors associated with infection, including surgical time, revisions and previous infection, have a greater impact on infection potential than material variation. Comparison of fabrication methods did highlight a notable effect on average infection rate. Trends can be observed showing that materials with greater levels of surface interaction and active support of tissue ingrowth presented greater infection resistance. Such characteristics are due to the physical structures of the implants. Conclusions: It can be said that the manufacturing methods can influence biomedical materials to assist in minimizing implant infection risk. View Full-Text
Keywords: cranioplasty; craniofacial; bone; reconstruction; material; graft; infection cranioplasty; craniofacial; bone; reconstruction; material; graft; infection
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Kwarcinski, J.; Boughton, P.; Ruys, A.; Doolan, A.; van Gelder, J. Cranioplasty and Craniofacial Reconstruction: A Review of Implant Material, Manufacturing Method and Infection Risk. Appl. Sci. 2017, 7, 276.

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