RESUMEN
To functionalize and improve the biocompatibility of the surface of a medical implant made of NiTi shape memory alloy and used in practice, a clamp, multifunctional layers composed of amorphous TiO2 interlayer, and a hydroxyapatite coating were produced. Electrophoresis, as an efficient method of surface modification, resulted in the formation of a uniform coating under a voltage of 60 V and deposition time of 30 s over the entire volume of the implant. The applied heat treatment (800 °C/2 h) let toa dense, crack-free, well-adhered HAp coating with a thickness of ca. 1.5 µm. and a high crack resistance to deformation associated with the induction of the shape memory effect in the in the deformation range similar to the real implant work after implantation. Moreover, the obtained coating featured a hydrophilic (CA = 59.4 ± 0.3°) and high biocompatibility.
RESUMEN
BACKGROUND: Anastomotic dehiscence and leaks are major problems in gastrointestinal surgery and result in increased morbidity and mortality. The ideal device to create anastomoses should ensure good serosal apposition without requiring either transgression of the bowel wall or the presence of foreign material for an extended period of time. OBJECTIVES: The aim of this experimental study was to evaluate the safety and efficacy of a new compression anastomosis clip (CAC) for jejunojejunostomies and ileocolostomies by comparing CAC anastomoses with hand-sewn (HS) anastomoses in pigs in terms of healing, breaking strength and the time to create anastomoses. MATERIAL AND METHODS: The 11 pigs in the study underwent side-to-side CAC and HS jejunojejunostomies and ileocolostomies, for a total of 88 anastomoses. The pigs were sacrificed on postoperative day 5 (5 pigs) or 7 (6 pigs). Macroscopic, histopathological and breaking-strength examinations were performed. The time to create the anastomoses was recorded. RESULTS: Neither group had anastomotic complications such as leakage or obstruction. Macroscopic examination showed no statistically significant differences between the groups. In the CAC group, the healing process was characterized by a lesser inflammatory reaction (p < 0.05) and very thin scar tissue at the anastomotic line (less collagen deposition and better epithelial regeneration), while the HS group had a much thicker anastomotic line. The breaking strength was significantly greater in the CAC group compared with the HS group (p < 0.05). The anastomosis time was shorter in the CAC group than in the HS group (p < 0.01). CONCLUSIONS: Anastomosis using a CAC appears to be safe and less time-consuming than HS; it was also characterized by a good healing process with little inflammatory reaction and a high breaking strength compared with HS anastomosis.
Asunto(s)
Colostomía , Ileostomía , Intestinos/cirugía , Yeyunostomía , Instrumentos Quirúrgicos , Técnicas de Sutura , Anastomosis Quirúrgica , Fuga Anastomótica/prevención & control , Animales , Colostomía/efectos adversos , Colostomía/instrumentación , Colostomía/métodos , Diseño de Equipo , Ileostomía/efectos adversos , Ileostomía/instrumentación , Ileostomía/métodos , Intestinos/patología , Yeyunostomía/efectos adversos , Yeyunostomía/instrumentación , Yeyunostomía/métodos , Masculino , Modelos Animales , Tempo Operativo , Presión , Sus scrofa , Técnicas de Sutura/efectos adversos , Factores de Tiempo , Cicatrización de HeridasRESUMEN
BACKGROUND: The aim of this study was to evaluate the efficacy of a compression anastomosis clip (CAC) for gastrojejunostomy and comparison of a novel technique with a hand-sewn anastomosis. METHODS: Sixty-six patients underwent gastrojejunostomy with the CAC or hand-sewn anastomosis. The time of bowel function recovery, the duration of nasogastric drainage, the time of initiation of oral feeding, the duration of postoperative hospital stay, the time needed to expel the clip, and the observation of any complications were recorded. RESULTS: Neither group had anastomotic complications such as leakage or obstruction. Anastomosis time was shorter in the CAC group than in the control group (P < 0.01). The mean time of clip expulsion was 15.1 ± 6.04 d. There was no statistical difference in postoperative results between the two groups. There was a moderate positive correlation between the day of first bowel movement and the day of clip expulsion (r = 0.536) and a strong correlation between the duration of nasogastric drainage and the day of clip expulsion (r = 0.881). CONCLUSIONS: The method of using a CAC appeared to be safe, easy, inexpensive, and less time consuming. It should be taken into consideration that intra-abdominal complications may cause delayed CAC expulsion.
Asunto(s)
Derivación Gástrica/instrumentación , Níquel , Neoplasias Pancreáticas/cirugía , Pancreatitis Crónica/cirugía , Instrumentos Quirúrgicos , Titanio , Adulto , Anciano , Anastomosis Quirúrgica/instrumentación , Anastomosis Quirúrgica/métodos , Fuga Anastomótica , Diseño de Equipo , Femenino , Derivación Gástrica/métodos , Humanos , Complicaciones Intraoperatorias , Masculino , Persona de Mediana Edad , Presión , Infección de la Herida Quirúrgica , Técnicas de SuturaRESUMEN
The paper presents an analysis of the distribution of dislocations in the case of fixation of a mandible low subcondylar fracture. Three types of elements have been used for fixation: NiTi shape-memory staples, miniaturized titanium plates and the Synthes compression plate, also called the Synthes zygomatic plate. The analysis was conducted using the finite element method. The degree of the mobility of the fractures was analysed as well as the tendency towards their separation on the basis of value analysis and the distribution of dislocation areas. The results obtained allowed a preliminary assessment of predicted healing effects and the possibility of being able to predict developing complications after osteosynthesis with the use of the elements analysed.
Asunto(s)
Fijación Interna de Fracturas/instrumentación , Fracturas Mandibulares/cirugía , Modelos Biológicos , Fenómenos Biomecánicos , Placas Óseas , Simulación por Computador , Humanos , Luxaciones Articulares/fisiopatología , Luxaciones Articulares/cirugía , Fracturas Mandibulares/fisiopatología , Níquel , Falla de Prótesis , Suturas , TitanioRESUMEN
As long as resection of sagittal suture eliminates craniostenosis it leads to desired cranium broadening and shortening solely in the case of children under six months of age. In the majority of cases, especially in older children, boat-shaped cranium remains rather unchanged and its effective modeling requires extensive dissection and osteotomy of the whole cranium vault (e.g., frontal, occipital and parietal bones). Lauritzen's method is an alternative solution. It consists of distraction of cranium vault bones with the aid of steel springs. In order to simplify and improve the efficacy of treatment since 2002, the authors originated the application of titanium-nickel rings to model the cranium. After the sparing excision of cranium vault sutures in the shape of letter "H" the compressed ring is given in the sagittal axis oval shape and in this form it is fixed to osseous margins. The ring's expansion at the same time broadens and shortens the cranium vault. Material was analyzed from 7 children (range, 9 months to 4 years of age), who were treated in the years 2002-2006 because of sagittal craniostenosis. Observations made so far and good treatment results indicate purposefulness of discussed treatment continuation.