Clinical Features of Skin Infection After Rhinoplasty with Only Absorbable Thread (Polydioxanone) in Oriental Traditional Medicine: A Case Series Study.

Background: Polydioxanone (PDO) is absorbable thread which is usually used for wound closure and face lifting. These days, PDO thread is used increasingly for aesthetic purposes such as correction of facial wrinkles, laxity and even rhinoplasty in many oriental traditional medicine clinics. As rhinoplasty with PDO thread increases, complications also increase. In this study, we will report on the clinical features of patients who got rhinoplasty using PDO thread.

Methods: From August 2018 to July 2019, seven patients (three males and four females) visited our clinic for complications after rhinoplasty with PDO thread. We checked ultrasonography and laboratory findings including wound cultures. We used conservative treatment using antibiotics and performed surgery on three patients.

Results: Three patients experienced severe complications with open wounds, abscesses and skin necrosis. Four patients experienced mild complications including redness and thread exposure without open wounds. The location of infection included the nasal tip and inner lining. Six patients had a history of rhinoplasty before. On ultrasonography, abscess formation was seen around the implant inserted before. During the operation, PDO thread cannot be seen except in one patient.

Conclusions: PDO thread cannot be seen in radiologic findings and can cause severe infections like abscess formation with open wounds. In severe infections, massive debridement with the removal of the implant would be required. PDO thread is absorbed usually after six months; mild infection can be controlled by the conservative treatment. The best is not undergoing rhinoplasty with PDO thread for patients who had implants because of potential side effects.

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.