Risk Factors Associated with Complications in Rhinoplasty Using Polydioxanone Plates

July O'Brien K, Kebede H, Porterfield JZ, Patel A, Gupta N.

PubMed 36414724 Publisher (DOI)Free full text (PMC)

What this paper says

Among 119 patients whose septum was rebuilt with a dissolvable polydioxanone plate, current smoking was significantly associated with early complications while diabetes showed no effect.

Overview

Polydioxanone plates are absorbable supports used to reconstruct the nasal septum during septorhinoplasty. The study analysed which factors affect short and long term complications after their use, focusing particularly on smoking and diabetes. It was a retrospective review examining risk factors and outcomes.

Sections of note

Retrospective review of 119 patients; the journal assigns level of evidence IV.
Early complications assessed were infection, blood collection, plate extrusion and septal thickening.
Late complications assessed were septal perforation, obstruction, revision and infection.
Complication rate was analysed against demographics, diabetes, smoking, autoimmune disease, cancer and trauma.
In multivariate analysis, current smoking had a large negative effect on late outcomes, odds ratio 2.00, 95 percent confidence interval 0.59 to 6.55.
Diabetes showed no significant difference in that analysis.
Targeted chi squared analysis showed a statistically significant effect of current smoking on early complications, odds ratio 3.65, 95 percent confidence interval 1.67 to 7.63.
The increase in long term complications with smoking was large but not statistically significant, odds ratio 4.20, 95 percent confidence interval 0.72 to 22.74.

What it means for a patient

Smoking roughly tripled the odds of an early complication after this type of septal reconstruction.
The long term smoking effect pointed the same way but the confidence interval is very wide, so it is not established.
Diabetes was not associated with increased complications in either analysis.
One hundred and nineteen patients from one centre reviewed retrospectively is limited evidence.

Why this paper matters

Absorbable plates are used to rebuild a septum too damaged to support itself, and whether patient factors affect their success has not been well studied. This review identifies smoking as the modifiable risk. The wide confidence intervals mean the size of that risk is uncertain.

Terms

Polydioxanone plate: a perforated absorbable plastic sheet used to support reconstructed cartilage.
Septorhinoplasty: surgery combining reshaping of the nose with correction of the septum.
Extrusion: an implant working its way out through the skin or lining.
Septal perforation: a hole through the central partition of the nose.
Odds ratio: how much more likely an event is in one group than another.
Multivariate analysis: a statistical method adjusting for several factors at once.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

Abstract

Objective: Polydioxanone (PDS) plates are utilized in septorhinoplasty to reconstruct the nasal septum. Our goal was to analyze factors affecting short- and long-term complications in patients undergoing septorhinoplasty using PDS plates with a particular focus on smoking and diabetes.

Methods: This is a retrospective review of patients undergoing septorhinoplasty with PDS plates analyzing risk factors and outcomes. Early complications included infection, hematoma, extrusion, and septal thickening. Late complications included septal perforation, obstruction, revision, and infection. Complication rate was assessed as a function of demographics, diabetes, smoking, autoimmune disease, cancer, and trauma. Multivariate analyses assessed the contributions of these variables, and Chi-square analyses specifically addressed smoking and diabetes.

Results: A total of 119 patients were included. In multivariate analysis, current smoking had a large negative effect on late outcomes (OR 2.00, 95% CI 0.59-6.55), while diabetes did not show any significant difference. Targeted Chi-squared analysis showed a statistically significant effect of current smoking on increased early complications (OR 3.65, 95% CI 1.67-7.63) and a large but not statistically significant increase in long-term complications (OR 4.20, 95% CI 0.72-22.74). In both models, diabetes was not shown to have an effect on early or late complications.

Conclusion: Current smokers undergoing septorhinoplasty with a PDS plate showed a statistically significant association with early complications and large but not statistically significant association with late complications. Diabetic patients were not found to have an increased complication risk.

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 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).