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Clinical and radiological characteristics of experimental fibrin gel application to optimization of reparative osteo-genesis
Bones injuries in small animals occupy a significant place in the structure of surgical pathology. Such treatment requires of maintance a stable fixation of bone fragments, and in case of bone defects formation - their replacement. The latter pay much attention while offering use as auto- or allografts and synthetic hydroxyapatite ceramic.
Many researchers suggest use biological materials that have osteoinductive or osteoconductive properties to optimize reparative process. Recently, this purpose in reconstructive orthopedics and traumatology have been widely implemented various compositions of autologous fibrin clot and platelet rich plasma.
Thus, the hemosis system plays a key role in the mechanisms of regenerative processes in tissues. This is primarily provided by activation of blood coagulation and clot formation at the site of damage, that in further is a matrix to form granulation tissue.
In the case of bone injuries presence of fibrin clot is equally essential for regenerative processes as organized fibrin between fractured bones is a ground for callus formation. At this time, spontaneous blood clot that forms immediately after bone damage usually breaks during bone fragments repositioning and osteosynthesis performs. To reconstruction this clot after osteosynthesis we proposed its restoration using autologous plasma, by its activation using ekamulin and application in the fracture area in experimental research on fractured rabbit’s radial bone.
The aim of the study was clinical and radiological justification of fibrin gel application to optimize reparative osteogenesis in rabbits.
Materials and methods. Investigation performed at the Department of Surgery and Diseases of Small Animals of Bila Tserkva National Agrarian University. In experiment used clinically healthy rabbits (n=7) 8 months of age, weighing 2.5 kg.
A broken bone is reproduced by osteotomy in the region of diaphysis of the right radius. Then the wound and bone fragments dried and deposited in the fracture area activated autologous plasma in the early stages of fibrin polymerization. The wound skin sewn seams nodal one minute after application of fibrin gel.
According to the clinical and radiological data it was found that on the 3rd day after the osteotomy in all animals manifested signs of pronounced inflammatory reaction surgical wounds, including swelling, redness and pain of injured tissues. Animals are not relied upon the injured limb.
Radiological noted transverse fractures with a distinct line of Fraktur. Lysis edges of bone fragments were observed. Reactions from the endo- and peryosta were absent.
On the seventh day after injury in experimental rabbits was observed decrease in the intensity of manifestation of inflammation. Thus, significantly reduced swelling and pain of the soft tissues. In this case there was no erythema. Animals lightly leaned on the sore limb.
Along with that in control rabbits was a distinct swelling, pain and tissue were recorded signs of erythema. Animals lightly leaned on the limb.
18th day in the experimental group of rabbits was characterized by the absence of signs of inflammation were observed radiographically moderate periosteal reaction zone fracture callus formation of connective tissue with well-defined processes of mineralization. Animals fully relied upon the limb.
Instead, the animals of the control group noted a marked soft tissue swelling and moderate their tenderness. Radiological noted massive, irregular periosteal reaction that lokalizuvalasya outside the defect. There was mild Tissue-specific patterns in the area of the defect with the initial stages of mineralization.
After 35 days, the reparative osteogenesis in rabbits of experimental group noted the full consolidation of bone fragments that radiographically detected fully formed cortical bone layer and faint periosteal reaction. Bone regenerate was in the final stages of remodeling. In animals, noted the complete restoration of function of the injured limb.
In rabbits in the control group on a background no signs of inflammation noted on radiographs as full consolidation of fragments of bone, restoring the integrity of the cortical layer of bone, but the injured bone still had excessive periosteal reaction that goes well beyond the defect. In animals, noted the complete restoration of function of the limb.
Conclusion. The use of fibrin gel in places fracture optimizes the reorganization of tissue structures and mineralization of bone regenerate the 3rd stage of reparative osteogenesis, clearly localizes regenerative processes within the injured skeletal sites and helps accelerate bone repair.
Key words: reparative osteogenesis, fibrin gel rabbits.
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