Material for plastic operations

FIELD: general surgery methods and facilities.

SUBSTANCE: material for various genesis, localization, and configuration defect grafting is made from thin (up to 100 mcm in diameter) titanium nickelid wire weaved into porous-permeable structure according to knitted-fabric and textile technology or by felting. Thanks to plasticity of titanium nickelid and quasiplasticity of woven structure, effective plasticity of material is many times superior to that in nonwoven porous sheet materials and meets requirements of congruent disposition of materials in organs and tissues to be operated.

EFFECT: increased plasticity of grafting material.

7 dwg

 

The invention relates to medicine, specifically to surgical technique for plastics fabrics and cover wounds.

Plastic tissue is a common name surgical methods to restore form or function of individual organs. This is done by moving (transplantation of tissues or implantation of replacement materials. Here, the term "material" refers not to the substance, and it made him semifinished product, the source for the production of a specific implant.

Functionally similar to plastic is sheltering tissues such as wounds, gaping holes, for protection from infection and/or tissue repair. In this role, the techniques employed (materials for plastics) must satisfy a number of prerequisites, such as:

1. Biocompatibility. Desirable minimum rejection reaction of a foreign object in the body.

2. Adequate physical-mechanical properties: plasticity and elasticity, cyclotouriste Flexural deformations, possibly less specific weight, the thickness of the material at the place of execution.

3. Adhesiveness (propityvaet body fluids) and water retention in the covered amount.

4. The corrosion resistance.

5. Ease of sterilization.

These and other important properties of these materials successfully implement the I through intensive development of science and technology of materials. A notable step in this direction was the development of materials with porous permeable structure, contributing to the optimization of the interaction of the material with living tissue. For medical purposes use a variety of biocompatible chemical compound.

Known porous metal (tantalum, titanium, alloys, niobium and others), porous non-metallic (ceramic, glass, polymers), natural (hydroxyapatite) materials with regular (texture knitted fabrics or textiles) and irregular (type "GIMP" or "felt") structures [1].

Materials for plastics with a regular structure conventionally refers to a porous, because the size of the individual elements of the structure and the distance between them in woven (textile) and knit (knitted) performance comparable with the statistical pore size in irregular porous materials. The dressing material such as gauze bandages can also be attributed to porous materials have been widely used to cover wounds.

Known materials for the plastic and cover tissues [1] in the form of a knitted or woven mesh of flexible wire of various bioinert metals and alloys: tungsten, molybdenum, nichrome, stainless, carbon steel, and, more recently, preferably titanium.

The combination of a flexible material, fibers, vasoproliferative due to a change in stitch patterns and a wide stretch of quasi-plastic deformation in the process flow and the partial destruction of the contact sites between the fibers causes the high plasticity of the material in General, when necessary manipulations them in specific and constrained conditions performed surgical operations.

The disadvantage of these materials is low integration ability with body tissues, high inflammatory reactivity and the possibility of rejection.

Known monolithic material for the plastic and cover tissues of the porous permeable alloy based on titanium nickelide, made in the form of a sheet of thin profile [2]. This material is used and showed their positive properties as a technical tool in plastic surgery for various tissues. In the specified similar it is used for plastic bone defects of the upper and middle zones of the skeleton of the face. The pore space of the implant during operation is filled with tissue fluids and the living tissues of the body, and the metal matrix becomes complex interaction with them, including mechanical, electrochemical and other

On the dynamics of tissue remodeling, nickelide titanium is superior to the now-famous medical supplies that are recognized in the Russian and global surgical practice.

Adopted by the similarity of the main characteristic of the source material for the prototype of the proposed material for the plastic has drawbacks.

The rigid structure of the material makes it difficult formoobrazovanie is e, congruent replacing the fabric or fill the space. The fragility of the material increases the risk of insolvency of the operation.

The technical result of the invention is the increase of plastic abilities are congruent with the replacement of tissues.

This technical result is achieved that the material for the plastic and cover tissues with porous structure of the super-elastic Nickel-titanium material structure formed filamentary fibers with transverse size of 10-100 microns, spaced at intervals not exceeding 3 mm.

The preferred knitted form the structure of the material.

Preferred textile form the structure of the material.

Preferred irregular shape patterns of the type "GIMP".

Preferably the execution of the fiber material in the form of one or a set of threads.

Achievable technical result concerning the prototype due to Rosvodokanal material, a movable connection of its elements. The layout of the fibers are presented in figures 1, 2, 3.

Knitted form (figure 1) patterns compared to textile (figure 2) has an additional degree of mobility of a single element, due to the Flexural deformation of the loops. Known from engineering experience for such structures and experimentally confirmed for structures, ispolnennyh Nickel-titanium, ductility exceeds the ductility of the prototype repeatedly. Functional properties of the material for the plastic - propityvaet body fluids and hold the volume of liquid (concealment) is provided by the organization of the effect of capillarity. For this purpose, the elements of the structure of the material fibers are located at relatively short distances from each other. For wetting liquids, which include body fluids on the surface of the Nickel-titanium, the thickness of the two liquid films on adjacent fibers located approximately defines the space between them, so that these films were closed. For the stated interval thickness fibers were experimentally determined limit value of the interval is 3 mm, the lower limit of the intervals may reach zero values, i.e. dense, but not practically achievable tightness arrangement of fibers, when the gap between them still exist and provide the capillary penetration of liquids.

Specifying the option offer is a structure of type "GIMP" (figure 3). It randomly matted and clumped in the required amount of wire (fiber), which in replacement operations must also meet the specified criteria.

The implementation of the fibers of the material, due to the desired plasticity and hydrophilicity and possible from the perspective of the technologist and necesitaremos wire, can vary from a single filament (monofilament) to two or more arranged in a row or hidden in a stranded complexes.

The illustrations presented:

Figure 1. The fragment patterns knitted material for the plastic and cover fabrics.

Figure 2. The fragment patterns of textile material for plastics and cover fabrics.

Figure 3. The structure of "rigmarole" of material for the plastic and cover fabrics.

Achievable technical result was confirmed experimentally laboratory comparative testing of materials made by the process of sintering and molding thin protoplanetary sheets (prototype) and knitting technology (proposed material). Efforts Flexural deformation vary speed. The amount of Flexural deformation of porous monolith does not exceed 10%. These materials allow to deform them in a large extent to mm radii of curvature that provides congruent placement of material in General surgical procedures on various organs and tissues and defects of any configuration.

Achievable technical result is due to the properties of wettability and capillarity. Vitalitea the structure of the material as a kind of permeable porous structure made of an alloy based on titanium nickelide, which is wetted to otnosheniy to tissue fluids of the body, in particular and mainly blood. The dimensions of the unit cells of the material characteristic of the capillary container of liquid. The phenomena of wetting and capillarity in the aggregate determine the dynamics of the behavior of the material placed in the liquid environment of the body. The liquid after the soaking structure, under the action of surface tension forces is held in the form of a film in the lumen of the cell. The strength retention is affected by the thickness of the yarn and the size of the lumen of the cell. The interdependence of these parameters are physically explicable and boils down to the fact that the strength retention is higher, the smaller the size of the lumen of the cell, and in the constancy of the latter - the thinner the thread. Thus, by varying the thickness of the thread, you can control the size of the cell under the condition of keeping it liquid film. In the proposed solution the selected diameter of the thread and the intervals, ensures retention, i.e. for the maximum value of the interval intervals of 3 mm can pick up the thread diameter less than 100 μm, and the maximum value of the thread diameter of 100 microns in length less than 3 mm, when the condition of holding the film is made.

Experimentally it is found that Nickel-titanium and characteristic of the liquid environment of the organism specified link is shown for the thread diameter up to 105-115 μm and sharply decreases with its increase beyond that.

<> In practical terms laid down in the proposed solution, the retention of the liquid film means the formation of a continuous, respiratory gases aerosols and bacteria surface, which is essential for surgical covering material.

In the material of the prototype, which is made by weaving nickeled-titanium filaments of a diameter of 120 μm and above at intervals of 1.5 mm, the retention effect is weak or absent.

An additional factor supporting the technical result is the presence on the surface of the microwire (diameter 100 μm) porosity (see figure 1, 2 (supplementary))generated in the process technology drawing. Porosity increases the effective surface of the thread and the strength of the surface-liquid bonds. With increasing diameter of the thread above 115 µm porosity decreases and disappears.

The declared dimensional characteristics of the material do not reduce and not eliminate its functionality as reinforcing material for plastic surgery. On the contrary, in cases where it is necessary to increase the strength of a reducible tissues, their relationship with the edges of the wound, the use of such a material is preferable.

Thus, the use of the identified properties of the mesh material extends its functionality through the ability to cover the wound surface, and non-obviousness and nei is having achieved popularity of these connections in the prior art demonstrates compliance proposals to the criterion of "inventive step".

For clarity of presentation the prototype and offered - here also pictures of the fragments made in the same scale. They can be used in addition to the illustrations of the primary materials of the application.

Additional illustrations:

4 and 5. Micrograph of the surface of nickeled-titanium filaments at different magnification with a diameter of 60 µm technology drawing.

6. The piece of material to plastic surgery (prototype).

7. A fragment of the material to plastic surgery.

The image scale is the same with 6.

Tested mesh-knitted materials (figure 1) from necesitaremos wire diameter of 45 μm. The distance between adjacent fibers were in different directions 0,5-3,0 mm

The material implanted in the tissue of the body, working on the dynamics, known for porous materials based on titanium nickelide, i.e. saturated liquid, is filled with time connecting and subsequent functional fabric, vascularities and innerviruetsya.

The state of the technological base of production of fibrous titanium nickelide, successful testing of the material in the clinical setting allow us to conclude about its industrial applicability.

Historicalinformation

1. Biocompatible materials and imp is entity shape memory. Edited Vaikunthera. Tomsk, Northampton, MA, 2001. P.9-11.

2. RF patent №20823-55 (prototype). Endoprostheses for the upper and middle zones of the facial skeleton.

Material for plastic surgery, which is formed by the interweaving of superplastic nikolicristanovic threads, characterized in that the selected thread with cross-sectional dimension of 10÷100 μm and are arranged in a woven structure of the material at intervals not exceeding 3 mm.



 

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