gms | German Medical Science

Introduction: This retrospective study summarises the complications that have developed in 26 patients treated with Bio-Alcamid® for Pectus excavatum, tries to determine risk factors and describes the management strategy employed to treat these adverse effects.

Material and methods: We describe a retrospective evaluation of 26 patients that underwent correction of Pectus excavatum with Bio-Alcamid® injections performed between 2004 and 2010 by the senior author.

Results: Out of the 26 patients 9 had complications, therefore the complication rate was 34.7%. Complications included migration of the filler, spontaneous discharge of the material, coalesced filler, hollowing due to migration of the material, swelling and localized inflammation, superficial soft tissue infection, severe infection with signs of sepsis. Not included in the statistic was mild inflammation, swelling or redness immediately after the injection of the material.

Treatment options for complications included aspiration of filler and/or pus with a large bore needle, drainage of filler through a 3mm punch hole, open excision in two selected cases plus antibiotic coverage. Two patients had custom made chest implants inserted at a later stage, the female patient had an exchange of her breast implants demonstrating severe capsular contracture and one patient opted for thoracic surgery.

Conclusion: Bio-Alcamid® may have significant long-term problems and we also think that its use should be restricted or discontinued entirely. Instead we favor the use of custom made silicone implants for treatment of contour defects of the chest in patients presenting with Pectus excavatum.