RESUMO
Introduction: megaprostheses are one of the most widely used treatments in oncological surgery, and one of its major complications is the high rate of infection. Methods: 30 patients underwent implantation of silver-coated Mutars® arthroplasty due to neoplastic disease or periprosthetic fracture. Clinical and analytical monitoring was performed with a minimum of 4 years follow-up. Results: During follow-up 3 infections (10% of patients) were detected, less than publications using non silver-coated prostheses. Conclusion: silver coating in megaprostheses seems to decrease infection rate. Methods: 30 patients underwent implantation of silver-coated Mutars® arthroplasty due to neoplastic disease or periprosthetic fracture. Clinical and analytical monitoring was performed with a minimum of 4 years follow-up. Results: During follow-up 3 infections (10% of patients) were detected, less than publications using non silver-coated prostheses. Conclusion: silver coating in megaprostheses seems to decrease infection rate. Results: During follow-up 3 infections (10% of patients) were detected, less than publications using non silver-coated prostheses. silver coating in megaprostheses seems to decrease infection rate. Conclusion: silver coating in megaprostheses seems to decrease infection rate.
Introducción: Las megaprótesis son uno de los tratamientos más usados en cirugía oncológica, y una de sus mayores complicaciones es la alta tasa de infección. Material y métodos: 30 pacientes fueron sometidos a la implantación de una artroplastia Mutars® con recubrimiento de plata debido a enfermedad neoplásica o fractura periprotésica. Se realizó un seguimiento clínico y analítico de los sujetos con un seguimiento mínimo de 4 años tras la intervención. Resultados: Durante el seguimiento se apreciaron 3 infecciones (10% de los pacientes) en la serie a estudio, cifra inferior a las publicaciones que usan prótesis sin recubrimiento de plata. Conclusión: el recubrimiento de plata en megaprótesis tumorales parece disminuir de la tasa de infección. Conclusión: el recubrimiento de plata en megaprótesis tumorales parece disminuir de la tasa de infección.
Assuntos
Artroplastia de Substituição/métodos , Neoplasias Ósseas/cirurgia , Materiais Revestidos Biocompatíveis/uso terapêutico , Neoplasias Femorais/cirurgia , Infecções Relacionadas à Prótese/prevenção & controle , Compostos de Prata/uso terapêutico , Tíbia/lesões , Artroplastia de Substituição/efeitos adversos , Seguimentos , HumanosRESUMO
Bioactive glasses (BGs) are promising materials for bone repair due to their desirable properties such as osteoconductivity, biodegradability, angiogenic potential, and antibacterial activity. Ionic dissolution products from bioactive glasses increase the medium pH inhibiting surrounding bacteria proliferation. The activity of BGs against biofilm formation has been enhanced by incorporating organic antibacterial compounds. The aim of this review was to summarize evidence in literature which assesses the efficacy of antibacterial and anti-biofilm compounds embedded in bioactive glasses to prevent peri-implant infection during bone healing. A PubMed bibliographical research was carried out including articles published in the last 20 years. Most previous studies evaluated antibacterial efficiency in planktonic cultures but did not investigate biofilm inhibition, underestimating biofilm clinical relevance. Multifactorial features such as biocompatibility of embedded compounds, receptor site characteristics, and drug delivery efficiency have been found to influence the bioactive glass capability of acting both as an anti-biofilm agent and as a bone repairing biomaterial. Accordingly, further in vitro and in vivo studies are required to select the most promising anti-biofilm agents which should be incorporated into bioactive glasses to counteract biofilm proliferation, without inducing toxic effects on human cells, and with the added functionality of promoting bone regeneration. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 672-679, 2017.
Assuntos
Anti-Infecciosos , Biofilmes/efeitos dos fármacos , Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos , Cerâmica , Materiais Revestidos Biocompatíveis , Animais , Anti-Infecciosos/química , Anti-Infecciosos/uso terapêutico , Biofilmes/crescimento & desenvolvimento , Substitutos Ósseos/química , Substitutos Ósseos/uso terapêutico , Cerâmica/química , Cerâmica/uso terapêutico , Materiais Revestidos Biocompatíveis/química , Materiais Revestidos Biocompatíveis/uso terapêutico , HumanosRESUMO
PURPOSE: To assess the systemic response of pigs to the intraperitoneal implantation of polypropylene mesh associated with chitosan-based film with a degree of deacetylation of 95%. METHODS: Blood samples were collected 24 hours before, and two and seven days after surgery. Systemic reactions were evaluated based on white blood cell count, C-reactive protein, and total serum protein, albumin and globulin levels. RESULTS: The systemic response was proportional to the composite response induced by polypropylene mesh, and the tissue inflammatory response was higher in the PP group (p=0.0033). CONCLUSION: The polypropylene mesh/chitosan-based film composite did not elicit a systemic response in pigs.
Assuntos
Parede Abdominal/cirurgia , Reação de Fase Aguda/etiologia , Quitosana/uso terapêutico , Materiais Revestidos Biocompatíveis/uso terapêutico , Polipropilenos/uso terapêutico , Telas Cirúrgicas , Animais , Proteína C-Reativa/análise , Contagem de Leucócitos , Masculino , Teste de Materiais , Cavidade Peritoneal/cirurgia , Distribuição Aleatória , Reprodutibilidade dos Testes , Albumina Sérica/análise , Soroglobulinas/análise , Suínos , Fatores de TempoRESUMO
PURPOSE:To assess the systemic response of pigs to the intraperitoneal implantation of polypropylene mesh associated with chitosan-based film with a degree of deacetylation of 95%.METHODS:Blood samples were collected 24 hours before, and two and seven days after surgery. Systemic reactions were evaluated based on white blood cell count, C-reactive protein, and total serum protein, albumin and globulin levels.RESULTS:The systemic response was proportional to the composite response induced by polypropylene mesh, and the tissue inflammatory response was higher in the PP group (p=0.0033).CONCLUSION:The polypropylene mesh/chitosan-based film composite did not elicit a systemic response in pigs.
Assuntos
Animais , Masculino , Parede Abdominal/cirurgia , Reação de Fase Aguda/etiologia , Quitosana/uso terapêutico , Materiais Revestidos Biocompatíveis/uso terapêutico , Polipropilenos/uso terapêutico , Telas Cirúrgicas , Proteína C-Reativa/análise , Contagem de Leucócitos , Teste de Materiais , Cavidade Peritoneal/cirurgia , Distribuição Aleatória , Reprodutibilidade dos Testes , Suínos , Albumina Sérica/análise , Soroglobulinas/análise , Fatores de TempoRESUMO
The use of meshes has become the first option for the treatment of soft tissue disorders as hernias and stress urinary incontinence and widely used in vaginal prolapse's treatment. However, complications related to mesh issues cannot be neglected. Various strategies have been used to improve tissue integration of prosthetic meshes and reduce related complications. The aim of this review is to present the state of art of mesh innovations, presenting the whole arsenal which has been studied worldwide since composite meshes, coated meshes, collagen's derived meshes and tissue engineered prostheses, with focus on its biocompatibility and technical innovations, especially for vaginal prolapse surgery.
Assuntos
Materiais Revestidos Biocompatíveis/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Telas Cirúrgicas , Prolapso Uterino/cirurgia , Implantes Absorvíveis , Feminino , Humanos , Invenções , Engenharia Tecidual/métodosRESUMO
ABSTRACTThe use of meshes has become the first option for the treatment of soft tissue disorders as hernias and stress urinary incontinence and widely used in vaginal prolapse's treatment. However, complications related to mesh issues cannot be neglected. Various strategies have been used to improve tissue integration of prosthetic meshes and reduce related complications. The aim of this review is to present the state of art of mesh innovations, presenting the whole arsenal which has been studied worldwide since composite meshes, coated meshes, collagen's derived meshes and tissue engineered prostheses, with focus on its biocompatibility and technical innovations, especially for vaginal prolapse surgery.
Assuntos
Feminino , Humanos , Materiais Revestidos Biocompatíveis/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Telas Cirúrgicas , Prolapso Uterino/cirurgia , Implantes Absorvíveis , Invenções , Engenharia Tecidual/métodosRESUMO
PURPOSE: To investigate abdominal wound healing using specific biomaterials in incisional hernias. METHODS: Incisional hernias were produced in 40 rabbits, after that they were reoperated with or without the use of meshes: PREMILENE® (PPL), ULTRAPRO® (UP), PROCEED® (PCD) or repairing without mesh (TRANSPALB). After 30 days a macroscopic and microscopic study of the part withdrawn from the abdominal wall was performed. RESULTS: Macroscopic: adhesion Area: PPL> UP and PCD (p = 0.031). Vascularization: PPL> UP and PCD (p = 0.001). PPL groups (p = 0.032) and PCD (p <0.001) showed greater meshes shrinkages when compared to UP. Microscopic: neutrophils: PCD> PPL, UP and TRANSPALB (p = 0.010); eosinophils: PPL> UP, and TRANSPALB PCD (p = 0.010); granulation tissue: PPL and PCD> UP and TRANSPALB (p <0.001); macrophages : PPL, UP and PCD> TRANSPALB (p <0.001); lymphocytes: PPL and PCD> UP (p = 0.009) and TRANSPALB (p <0.001); giant cells: PPL, UP and PCD> TRANSPALB (p <0.001); viscera adhered: PPL and UP> PCD and TRANSPALB (p <0.001). CONCLUSION: All types of meshes caused the formation of adhesions. The UP and PCD groups showed lower area and vascularization of the adhesions. The PPL and PCD groups showed higher meshes shrinkage and there was a predominance of acute inflammatory process in the PCD group.
Assuntos
Parede Abdominal/cirurgia , Materiais Revestidos Biocompatíveis/uso terapêutico , Hérnia Abdominal/cirurgia , Telas Cirúrgicas , Cicatrização , Parede Abdominal/patologia , Animais , Masculino , Teste de Materiais , Polipropilenos/uso terapêutico , Coelhos , Reprodutibilidade dos Testes , Fatores de Tempo , Aderências Teciduais , Resultado do TratamentoRESUMO
PURPOSE: To investigate abdominal wound healing using specific biomaterials in incisional hernias. METHODS: Incisional hernias were produced in 40 rabbits, after that they were reoperated with or without the use of meshes: PREMILENE® (PPL), ULTRAPRO® (UP), PROCEED® (PCD) or repairing without mesh (TRANSPALB). After 30 days a macroscopic and microscopic study of the part withdrawn from the abdominal wall was performed. RESULTS: Macroscopic: adhesion Area: PPL> UP and PCD (p = 0.031). Vascularization: PPL> UP and PCD (p = 0.001). PPL groups (p = 0.032) and PCD (p <0.001) showed greater meshes shrinkages when compared to UP. Microscopic: neutrophils: PCD> PPL, UP and TRANSPALB (p = 0.010); eosinophils: PPL> UP, and TRANSPALB PCD (p = 0.010); granulation tissue: PPL and PCD> UP and TRANSPALB (p <0.001); macrophages : PPL, UP and PCD> TRANSPALB (p <0.001); lymphocytes: PPL and PCD> UP (p = 0.009) and TRANSPALB (p <0.001); giant cells: PPL, UP and PCD> TRANSPALB (p <0.001); viscera adhered: PPL and UP> PCD and TRANSPALB (p <0.001). CONCLUSION: All types of meshes caused the formation of adhesions. The UP and PCD groups showed lower area and vascularization of the adhesions. The PPL and PCD groups showed higher meshes shrinkage and there was a predominance of acute inflammatory process in the PCD group.
Assuntos
Animais , Masculino , Coelhos , Parede Abdominal/cirurgia , Materiais Revestidos Biocompatíveis/uso terapêutico , Hérnia Abdominal/cirurgia , Telas Cirúrgicas , Cicatrização , Parede Abdominal/patologia , Teste de Materiais , Polipropilenos/uso terapêutico , Reprodutibilidade dos Testes , Fatores de Tempo , Aderências Teciduais , Resultado do TratamentoRESUMO
We aimed to test a new model of self-expanding tracheal stent so that it might be made available for clinical use. Using direct laryngoscopy, we placed polyurethane-coated, nitinol stents into the middle third of the trachea in 25 New Zealand rabbits. After a mean observation period of 26 days, we evaluated stent migration, degree of expansion, attachment, adherence, formation of granulation tissue, presence of inflammatory infiltrate, parietal involvement, and epithelial lining. The results showed complete radial expansion, little adherence to the tracheal mucosa, and low tissue attachment, as well as high rates of granuloma formation and stent migration. This new model proved to be biocompatible and showed a behavior similar to that of other stents on the market.
Assuntos
Ligas , Materiais Revestidos Biocompatíveis/uso terapêutico , Poliuretanos , Desenho de Prótese , Stents , Estenose Traqueal/cirurgia , Animais , Brasil , Coelhos , Stents/efeitos adversosRESUMO
Titanium surface texture and chemistry modification successfully improves the host response and consequently the bone-to-implant contact surrounding dental implants. The aim of the present study was to investigate, using histomorphometrical-analysis, the effects of titanium surface modification by laser-ablation (Nd:YAG) followed by thin chemical deposition of HA. Forty-eight rabbits received one implant by tibiae of AS-machined (MS), laser-modified (LMS), or biomimetic hydroxyapatite-coated (HA) surface. Bone-to-implant contact (BIC) and bone area (BBT) were evaluated after 4, 8, and 12 weeks, at cortical and cancellous regions. Average BIC in the cortical region was higher (P < 0.001) on the LMS and HA implants for all periods, with no differences between LMS and HA. For the cancellous area, the LMS and HA implants showed higher (P < 0.01) BIC than MS at the initial periods. The LMS and HA showed similar values in the cortical region, but a tendency of higher values for HA in the cancellous region was observed in all periods. For the BBT, the differences were found only between HA and MS after 4 weeks in the cortical region (P < 0.05), and after 12 weeks in the cancellous area (P < 0.05). Our results showed that HA biomimetic coating preceded by laser treatment induced the contact osteogenesis and allowed the formation of a more stable bone-implant interface, even in earlier periods.