RU2789497C1 - Method for preparation of biological tissue for transplantation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: present invention relates to the field of medicine, in particular surgery, namely to a method for preparing biological tissue for transplantation. To implement the method, a preservative solution is prepared by mixing 100 ml of perfluorane emulsion and 2 g of Ceftriaxone. Then the preserving solution is placed in the Bobrov apparatus, through which pure oxygen is supplied at a rate of 2-4 liters/min for 15-30 minutes. At the same time, an excised auto-skin graft is prepared by de-epithelizing and perforating it in a staggered manner, with a perforation diameter of 0.3-0.4 cm, followed by placing the graft in a prepared preservative solution for 40-60 minutes.

EFFECT: present invention makes it possible to preserve the physical properties of a skin graft, increasing its antibacterial activity in the early stages after implantation, and ensures the engraftment of the graft during regeneration.

1 cl, 2 ex

Description

The invention relates to medicine, namely to surgery, and can be used to prepare biological tissue for transplantation.

The problem of surgical treatment of ventral hernias remains relevant despite the progress in this area. The widespread introduction of alloimplants, although they solved some problems in the plastic of the anterior abdominal wall, but many researchers believe that the use of biological implants is optimal for eliminating defects in the anterior abdominal wall. As a plastic material in bioimplants, the dura mater, the peritoneum of cattle, etc. are used. Autoderma is one of these materials.

From the practice of medicine, methods for preserving biological tissue based on the use of formaldehyde are known (AC 1012856), a method for preserving biological tissue for transplantation is also known, containing a 0.9% solution of sodium chloride with an antibiotic, imoxipin and glycerin dissolved in it (RU 2212793, 2003 ).

A known method of conservation of biological implants (V.A. Dorovskikh RU 2148318), which is a prototype, consists in the fact that the treatment of allobrefomaterial is carried out with an antibiotic solution and conservation in a 0.9% sodium chloride solution with an antibiotic dissolved in it and isothiorbamine as an antioxidant. However, the proposed solution as a biological tissue preservative has disadvantages:

- does not give elasticity and strength to the preserved tissue;

- does not enhance antimicrobial activity on hospital strains of bacteria.

The proposed method for preparing biological tissue for transplantation is aimed at maintaining the physical properties of the skin graft (elasticity, strength), enhancing antimicrobial activity, and increasing the area of the graft.

This technical result is achieved by mixing 100 ml of perftoran emulsion and 2 g of Ceftriaxone to prepare the preservative solution, then the preservative solution is placed in the Bobrov apparatus, through which pure oxygen is supplied at a rate of 2-4 l / min for 15-30 minutes, at the same time, the excised autodermal graft is prepared, deepithelizing and perforating it in a checkerboard pattern with a perforation diameter of 0.3-0.4 cm, followed by placing the graft in the prepared preservative solution for 40-60 minutes.

In the claimed method, it is proposed to preserve a skin autograft in a prepared solution that contains an emulsion of perftoran. The drug has gas transport, rheological, hemodynamic properties that enhance the regenerative activity of the cellular and biochemical components of the inflammatory wound process and contribute to a faster transition of the wound process to the regeneration phase (Emulsion for inf. 10 g/100 ml: vial. 50, 100, 200 or 400 ml registration No: Р N001962/01 dated 08/07/08 - Indefinitely, Re-registration date: 04/27/16).

Bobrov's apparatus (Kanel V.Ya. Course of nursing / Under the editorship of A.Yu. Kanel, S.S. Molodenkov, G.G. Yaure. - 7th ed. - M. - L .: State Medical Publisher, 1931. - P. 232-234. - 531 pp. Oxygen therapy // Great Russian encyclopedia: [in 35 volumes] / editor-in-chief Yu.S. Osipov. - M.: Great Russian encyclopedia, 2004 -2017.) with a perftoran emulsion, through which oxygen is supplied for 15-30 minutes, is designed to maximize the saturation of the emulsion with oxygen, and the increased oxygen content in the perftoran emulsion and impregnated skin graft reduces hypoxia, increases the desensitizing effect, ensuring engraftment in the regeneration process.

The use of ceftriaxone is due to the fact that it is a more effective broad-spectrum antibiotic used in practical medicine.

Deepithelization of the skin flap in the proposed method is performed using a dermatome, which allows you to completely remove the epidermal layer and adjust the thickness of the cut layer of the skin, and perforation of the graft in a checkerboard pattern with perforated holes of 0.3-0.4 cm, increases not only the area of the flap, but also the contact of the tissue with the solution .

The proposed method was tested at the Department of General Surgery of the Astrakhan State Medical University of the Ministry of Health of Russia and GBUZ JSC City Clinical Hospital No. 3 named after S.M. Kirov, Astrakhan.

Below are the test results.

Example 1: Patient S., 54 years old. She was admitted in 2021 for an umbilical hernia and a hernia of the linea alba. She has been ill for 8 years in anamnesis. Over the past two years, there has been a significant increase in hernial protrusions. An elliptical incision along the hernial protrusion excised a skin flap with subcutaneous tissue. The subcutaneous tissue was excised with curved scissors. Deepithelialization of the skin autograft was performed using a dermatome. The thickness of the prepared graft was 0.18 cm. The skin graft was perforated in a checkerboard pattern with perforated holes of 0.3 cm. In parallel with the preparation of the flap, a preservative solution was prepared. Perftoran emulsion in the amount of 100 ml was mixed with 2 g of Ceftriaxone and placed in the Bobrov apparatus, through which pure oxygen was supplied at a pressure of 2 l/min for 15 minutes.

Measured Po ₂ emulsion after oxygenation, which is an indicator of oxygen saturation of the perftoran emulsion. The indicator was 58.3 kPa. The prepared skin autograft is placed in the prepared solution prior to autodermoplasty. The exposure in the solution before implantation was 40 minutes.

Given that the patient suffers from II degree obesity, she had atrophy of the muscular-aponeurotic structures of the anterior abdominal wall. Therefore, it was decided to fix the skin autograft prepared by the described method sub-lay. The postoperative period proceeded without complications. The patient was discharged in a satisfactory condition.

Example 2: Patient A., aged 59. In 2021, he was admitted with a diagnosis of postoperative ventral hernia. Two fringing incisions along the hernial protrusion excised a skin flap with subcutaneous tissue and postoperative scar. Excised subcutaneous tissue. Deepithelialization of the skin autograft was performed using a dermatome. The thickness of the prepared graft was 0.2 cm. The skin graft was perforated in a checkerboard pattern with perforated holes of 0.4 cm. In parallel, when cutting out and preparing the flap, a preservative was prepared. Perftoran emulsion in the amount of 100 ml is mixed with 2 g of Ceftriaxone and placed in the Bobrov apparatus, through which pure oxygen was supplied at a pressure of 4 l/min for 30 minutes. When measuring the Po ₂ index of the emulsion, it was 82.6 kPa, which is an indicator of oxygen saturation of the perftoran emulsion. The finished skin autograft is placed in the prepared solution prior to autodermoplasty. The exposure in the solution before implantation was 60 minutes. Herniotomy was performed with strengthening of the anterior abdominal wall with an autograft prepared in the described manner with sub-lay fixation. The postoperative period proceeded without complications. Discharged in a satisfactory condition.

The proposed method of preparation of biological tissue allows you to save the physical properties of the skin graft, increasing its antibacterial activity in the early stages after implantation and ensures engraftment in the process of regeneration.

Claims (1)

A method for preparing biological tissue for transplantation based on the use of antibiotics in a preservative solution, characterized in that to prepare the preservative solution, 100 ml of perftoran emulsion and 2 g of Ceftriaxone should be mixed, then the preservative solution is placed into the Bobrov apparatus, through which at a rate of 2-4 l /min, pure oxygen is supplied for 15-30 minutes, at the same time, an excised autodermal graft is prepared, deepithelizing and perforating it in a checkerboard pattern with a perforation diameter of 0.3-0.4 cm, followed by placing the graft in the prepared preservative solution for 40-60 minutes .