Integrated Perioperative Infection Management Measures (PSMS-11) for ePTFE Rhinoplasty in East Asian Patients: A Large-Sample, Long-Term Retrospective Study.

BACKGROUND

Expanded polytetrafluoroethylene (ePTFE) has been widely utilized in east Asian rhinoplasty due to its favorable stability and biocompatibility. However, postoperative infection which is one of the major complications affecting surgical outcomes and patient satisfaction presents receive much concern. Evidence based on large cohorts with long-term follow-up in this population remains limited.

METHODS

A retrospective review of 1153 consecutive patients who underwent ePTFE rhinoplasty at our institution from January 2018 to December 2024 was performed. We compared Demographics, surgical techniques, and postoperative outcomes between infected and non-infected cases to identify risk factors for infection. Based on literature review and accumulated clinical experience, a perioperative systematic management strategy-11 Decision Nodes (PSMS-11) was applied consistently in routine practice. Infection characteristics, management approaches, and long-term outcomes were evaluated.

RESULTS

Postoperative infection occurred in a small proportion of patients, with an overall incidence of approximately 1.6% during long-term follow-up. Notably, more than half of infection events presented beyond six months after surgery, including late-onset cases occurring more than one year postoperatively. Revision surgery, active skin inflammation, smoking history, and unfavorable postoperative behaviors were associated with increased infection risk. Early localized infections could be considered for conservative management under close surveillance, whereas persistent or progressive infections required implant removal.

CONCLUSIONS

In this large-sample, long-term retrospective study of East Asian patients, a consistently low infection rate was observed following ePTFE rhinoplasty. These findings suggest that structured integration of perioperative management measures, as summarized by PSMS-11, may contribute to maintaining low infection rates in high-volume clinical practice. Long-term follow-up and individualized treatment decisions remain essential.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .