RU2330684C1 - Method of application of thrombocyte enriched plasma membrane for directed regeneration of modified vascular wall tissue in cases of potential postoperative hemorrhage - Google Patents

Abstract

FIELD: medicine; surgery.

SUBSTANCE: directed regeneration of injured or atrophic modified vascular wall tissue in cases of potential postoperative haemorrhage implies application of thrombocyte enriched plasma membrane made of blood taken from patient before operation through fractionating.

EFFECT: method enables to prevent postoperative haemorrhage of injured or atrophic modified great vessel walls.

1 dwg, 1 ex

Description

The invention relates to medicine, namely to surgery.

To prevent postoperative bleeding from injured or atrophically altered walls of the main vessels of the neck, various adhesive substances have been used earlier and at present. The most traditional hemostatic topical agent is collagen, which serves as a matrix for the formation of a blood clot by trapping platelets (analogue, it is also a prototype). However, the hemostatic capabilities of collagen sponges are very limited due to poor fixation to the wound surface, which leads to their rapid rejection.

The objective of the invention is a method of preventing postoperative bleeding from injured or atrophically altered walls of the main vessels of the neck by using a plasma membrane enriched with platelets, not previously used.

The task is achieved using the proposed new method, the essence of which is as follows: in order to prevent postoperative bleeding from injured or atrophically altered vessel walls and an increased risk of vascular suture failure, we resorted to additional strengthening of these sites with autoplasma enriched with platelets in the form of a membrane for directed regeneration damaged tissue. The procedure for its preparation is as follows. Before surgery, a patient was taken from the ulnar vein in an amount adequate to the volume required for this operation, usually no more than 6 tubes. To obtain POT, an OPN-3 centrifuge was used, which allows blood to be fractionated simultaneously in 10 test tubes. After blood sampling, the tubes were immediately placed in a centrifuge. For safe operation of the apparatus, an even number of tubes is always set opposite each other. Blood centrifugation was carried out for 15 min at 3000 rpm. After centrifugation, the blood was divided into three parts: erythrocytes precipitate in the lower part, and plasma with a low platelet content in the upper part. Between these two fractions is a clot with a high platelet content. In a test tube with plasma contains 2-3 million platelets and all white blood cells (this provides local antibacterial action). The blood components obtained by centrifugation were used in terms not exceeding 3 hours. The upper layer of depleted platelet plasma merged and, if necessary, was used as a medium for temporary storage of plastic material. Then the gel was taken out of the tube with tweezers and scissors were separated from the erythrocyte mass. In a sterile gauze napkin under aseptic conditions, the gel was squeezed uniformly until a membrane was obtained, which strengthened the necessary zone of the vessel with a capture of 2-3 cm of healthy tissue on each side.

After removal of the metastases of the neck that were soldered to the neurovascular bundles, a membrane was applied to prevent bleeding or rupture of the wall on the areas of atrophically altered vessel walls or on the resected portion of the vessel with the vascular suture.

The invention is illustrated by the drawing, which shows a portion of the vessel, which is covered by a plasma membrane enriched in thromboconcentrate.

The method is as follows.

To prevent postoperative bleeding from injured and atrophically altered walls of the main vessels of the neck and strengthen vascular sutures, a membrane enriched with platelets is used, which strengthened the necessary vessel wound with the capture of 2-3 cm of healthy tissue on each side and fixation with a thin catgut. drawing.

An example of clinical application.

Patient M., was admitted to COOD on June 19, 2005. The diagnosis was cancer of the mucous membrane of the bottom of the oral cavity, art. IIIb kg IIa T3N1M0 condition after preoperative radiation therapy in SOD 44 Gy. After preoperative preparation, 06/22/2005 - tracheostomy, sheath-fascial cervical dissection from 2 sides, resection of the bottom of the oral cavity, chin of the lower jaw. Closing of bifurcation of the common carotid artery and stump of the ligated common facial vein with a plasma membrane enriched with platelets of autologous blood after removal of intimate-soldered metastasis with vascular walls from this zone. The postoperative period without complications, healing by first intention. The patient was discharged 07/31/2006

Thus, the proposed technique for preventing postoperative bleeding from injured or atrophically altered walls of the main vessels of the neck and an increased risk of vascular suture failure was applied in 10 patients and proved to be a reliable way to deal with this formidable complication.

Claims (1)

A method for targeted tissue regeneration of an injured or atrophically altered vascular wall in cases of risk of postoperative bleeding, characterized in that a plasma membrane enriched with platelets is used, prepared from blood taken from a patient before surgery by fractionation.

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