Avoiding pitfalls in craniofacial reconstruction using absorbable plates.

Rigid internal fixation devices are a mainstay in craniofacial surgery. The advent of absorbable plates has been a monumental advancement and has proven to be a safe and effective method of osteofixation. It has been proposed that many problems of the permanent metallic implants can be avoided by the use of resorbable plates. Exposure is thought to be secondary to tissue tension over the plates and breakdown of the overlying tissue envelope. This a report of 2 cases of craniosynostosis reconstruction with absorbable plate exposure through overlying skin incisions necessitating plate removal and revisionary surgery. This study proposes that imprudent plate placement traversing overlying skin incisions may more likely result in absorable hardware exposure. Careful preoperative planning of skin incisions and proposed hardware placement are a strategy to avoid absorbable plate exposure in craniosynostosis reconstruction.