Autograft for replacement of bone cavity in treatment of chronic osteomyelitis

FIELD: medicine.

SUBSTANCE: autograft is made as mixture of minced muscular auto-issue with the concentrated serum autofibronectin in proportion 1:(0.2-0.5).

EFFECT: autograft reduces the treatment and prevents the post-operational complications.

1 ex

 

The invention relates to medicine, specifically to the treatment of chronic posttraumatic osteomyelitis by replacement of the bone cavity transplant.

Currently surgical treatment of chronic posttraumatic osteomyelitis is universally acknowledged as the most effective.

Known graft, made of allocate (1).

The disadvantage of this transplant is a long term rehabilitation and the possibility of postoperative complications.

Known elastic porous biomaterial, which have antibacterial properties (2).

The disadvantage of this material is a high probability of occurrence of postoperative complications.

Known graft made of biological tissue (3).

The disadvantage of this transplant is a long term rehabilitation of bone tissue.

There is a method of treatment of chronic posttraumatic osteomyelitis by necrsequestrectomy followed by grafting diseased cavity demineralized bone graft (4).

The disadvantage of this method is the high likelihood of postoperative complications and long term treatment.

There is a method of treatment of osteomyelitis by necrsequestrectomy with subsequent grafting of the affected bands and transplant(5).

The disadvantage of this method and applied transplant is a long term treatment with the possibility of postoperative complications.

There is a method of treatment of chronic osteomyelitis by necrsequestrectomy and replacement of the bone cavity with bone autograft(6).

The disadvantages of this method and applied bone autograft are long term treatment of the patient and the possibility of postoperative complications.

The aim of the invention is to reduce the duration of treatment and elimination of the possibility of postoperative complications.

This goal is achieved by the fact that it is made in the form of a mixture of crushed muscle autotune with concentrate plasma autofinancing in a volume ratio 1:(0,2-0,5).

The comparison of the proposed autograft with other known in medicine has demonstrated its compliance with the criteria of the invention.

The invention is based on the concentration of plasma autofinancing.

Fibronectin is one of the blood components, representing a high molecular weight glycoprotein (MM=210-250 kDa)found in many types of connective tissue near the cytoplasmic membrane of cells. In the structure of fibronectin are functionally active centers capable of interacting with fibrin, factor plasma XIIa, collagenoma gelatin, immune complexes, cell membrane, heparin.

Fibronectin, being one of the major opsonins, clears the blood from different targets phagocytosis, capturing and bringing through the cells and organs macrophage system of the body.

Another function of plasma fibronectin is involved in the processes of healing of vascular and tissue defects. Fibronectin figuratively referred to as molecular glue, because it connects the collagen fibers glycosaminoglycan, fibrin, etc. This connection plays an active role in the process of cellular differentiation. He appears in the embryonic mesenchyme simultaneously with collagen type I in period condensing cartilage blastoma and participates in chondrogenesis. Fibronectin performs the function of biological regulator of the metabolism of collagen during wound healing. The normal concentration of fibronectin in blood is about 300 mg/ml

Concentrate fibronectin derived from human blood plasma, where its content is 300 µg/ml and in clinical practice it is called the concentrate of plasma fibronectin.

Concentrate plasma autofinancing is produced from the blood of a patient from whom it is to be applied . It is derived as follows:

in the blood plasma, placed in the package is added to the heparin based 15-20000 E is/liter and then incubated 18-24 hours in the refrigerator at a temperature of 4-6° (During this period, the plasma is formed precipitate, which contains fibronectin);

after incubation, the plasma is subjected to centrifugation for 8-10 minutes, at a temperature of -4°and speed 3500 rpm;

- pressed sludge containing fibronectin, dissolved in 30 ml of trisamine or 50 ml of a 7% solution of soda until dissolved. The content of fibronectin in the resulting concentrate is from 1000 to 1500 µg/ml;

- obtained liquid is packaged and frozen. Activity in the frozen state fibronectin stores within 10-16 days.

Before using the obtained concentrate, thawed at room temperature.

Autograft to replace bone cavity in the treatment of chronic posttraumatic osteomyelitis is made in the form of a mixture of crushed muscle autotune with concentrate plasma autofinancing in a volume ratio 1:(0,2-0,5).

Autograft is used as follows.

Using traditional methods receive the same amount of shredded muscle mass autotune patient.

From the blood of the patient on the above methodology are getting the proper amount of concentrate plasma autofinancing.

One of the known methods of preparing a bone cavity to replacement by transplant. Put the prepared mixture AU is transplantat with concentrate plasma autofinancing in the bone cavity layers and close the wound.

Clinical example. Patient S., aged 45, is undergoing treatment for chronic post-traumatic osteomyelitis of the left tibia. The disease duration of 3 years, almost every year underwent inpatient treatment in hospitals of our city. During the last hospitalization performed surgery - necrsequestrectomy. The size of the bone cavity 23×20×7 mm. Prepared mixture of shredded muscle autotune with concentrate plasma autofinancing in a volume ratio of 1:0.3 to. The bone cavity is filled with the prepared autotransplantation, when layers have tighten up her wound tightly. The wound healed on day 9 with good long-term results.

The proposed use of autograft allows you to optimize, to significantly reduce the treatment time, to reduce the risk of postoperative complications and significantly reduce the economic costs of treatment of patients with this pathology.

This graft can be used in purulent surgery medical institutions for the treatment of chronic posttraumatic osteomyelitis.

Sources of information

1. Auth. mon. The USSR №1082420, CL AV 17/48, 1984.

2. Hilkin A.M., A.B. Shekhter, Istrana L.P., Lemeshev, VA Collagen and its application in m is dicine. M.: Medicine, 1983. - .183-209.

3. Auth. mon. The USSR №1055484, CL AV 17/01, 1983.

4. Khomich I.I. Chronic osteomyelitis. Minsk: 1977. - P.70.

5. Carpenters E.A., D. Grachev and other Surgical infection. - Samara, 2004. S-135.

6. Nikitin GD, Cancer A.V. and other Surgical treatment of osteomyelitis. St. Petersburg, 2000. - S-204.

Autograft to replace bone cavity in the treatment of chronic osteomyelitis, made in the form of crushed muscle tissue, characterized in that the autograft is made in the form of a mixture of muscle tissue with the plasma concentrate autofinancing in a volume ratio 1:(0,2-0,5).



 

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