Abscess formation caused by a foreign body reaction to a poly-d, l-lactic acid (PDLLA) absorbable plate for zygomaticomaxillary complex (ZMC) fracture

Abstract

BackgroundThe poly-d, l-lactic acid absorbable plate does not contain poly l-lactic acid, which is the main factor in foreign body reactions; therefore, with use of this plate, a foreign body reaction is unlikely. In fact, few reports have been published on removal of a poly-d, l-lactic acid absorbable plate owing to a foreign body reaction.Case presentationWe report a case of abscess formation that led finally to the removal of a poly-d, l-lactic acid absorbable plate. A 45-years-old man with a left zygomaticomaxillary complex fracture sustained during a fall underwent open reduction using the poly-d, l-lactic acid absorbable plate. Fourteen months after the operation, he was admitted to our hospital with swelling and redness of the left lateral part of the upper eyelid. Upon incision of the swelling, we found a large amount of purulent drainage and the plate in broken fragments and removed as many of the fragments as possible. The swelling was improved after drainage of the incision twice and use of antibiotics, and the bacterial culture results were negative. No recurrence or aggravation was observed after the drainage.ConclusionsWe suspected sterile abscess formation secondary to a foreign body reaction to the poly-d, l-lactic acid absorbable plate. Given that the poly-d, l-lactic acid absorbable plate is absorbed over a period of more than 1 year postoperatively, long-term follow-up of injuries treated using the plate may be required. Furthermore, surgical intervention, such as drainage or removal, should be considered if the foreign body reaction symptoms are severe.