An inflammatory reaction to stored fascia lata 37 years post-implantation
What:
Paper Presentation | Présentation d'article
Part of:
When:
2:02 PM, Friday 1 Jun 2018
(6 minutes)
Where:
Metro Toronto Convention Centre (South Building)
- Room 714 A
How:
Authors: David R. Jordan, Kaisra Esmail, Seymour Brownsteion, Tina Tang, Bruce Burns
Author Disclosure Block: D.R. Jordan: None. K. Esmail: None. S. Brownsteion: None. T. Tang: None. B. Burns: None.
Abstract Body:
Purpose: To describe a reaction to stored fascia lata 37 years post implantation.
Study Design: Case report.
Methods: Review of single patient history and treatment record.
Results: Methotrexate was required for several years to keep the inflammatory reaction quiet.
Conclusions: Stored fascia lata has been used in several surgical specialties including ophthalmology, neurosurgery, urogynecology, oral surgery as well as cosmetic surgery. Within ophthalmology, it has been utilized as a suspensory material in frontalis sling surgery, as an orbital floor implant and as a patch graft during glaucoma filtering surgery.1,2,3 Complications are uncommon but may include early localized inflammatory reactions, infection, and granuloma formation.4,5,6 The authors report a suspected inflammatory reaction to stored fascia lata 37 years’ post-placement. The authors suspect there may have been a delayed inflammatory reaction to a component of the autologous fascia graft that was not completely inactivated by the original sterilization technique. To our knowledge, this type of delayed inflammatory reaction has not been previously reported. It raises a concern about the use of autologous donor tissue and accepted sterilization techniques that may not be 100% effective in deactivating all components of the donor graft causing a subsequent latent reaction.
Author Disclosure Block: D.R. Jordan: None. K. Esmail: None. S. Brownsteion: None. T. Tang: None. B. Burns: None.
Abstract Body:
Purpose: To describe a reaction to stored fascia lata 37 years post implantation.
Study Design: Case report.
Methods: Review of single patient history and treatment record.
Results: Methotrexate was required for several years to keep the inflammatory reaction quiet.
Conclusions: Stored fascia lata has been used in several surgical specialties including ophthalmology, neurosurgery, urogynecology, oral surgery as well as cosmetic surgery. Within ophthalmology, it has been utilized as a suspensory material in frontalis sling surgery, as an orbital floor implant and as a patch graft during glaucoma filtering surgery.1,2,3 Complications are uncommon but may include early localized inflammatory reactions, infection, and granuloma formation.4,5,6 The authors report a suspected inflammatory reaction to stored fascia lata 37 years’ post-placement. The authors suspect there may have been a delayed inflammatory reaction to a component of the autologous fascia graft that was not completely inactivated by the original sterilization technique. To our knowledge, this type of delayed inflammatory reaction has not been previously reported. It raises a concern about the use of autologous donor tissue and accepted sterilization techniques that may not be 100% effective in deactivating all components of the donor graft causing a subsequent latent reaction.
