Comments: for the research authors of the article have been supplied with the material “ Titanium silk”
“Clinical diagnostic center of gastroenterology”, Vet clinic “ Endovet” Kurgan city, scientific practical conference devoted to 200 years anniversary of Pirogov 2009.
Background. Implantation techniques are becoming more and more important in modern medicine. Biocompatible implant materials are widely used in surgery, traumatology, cardiovascular surgery, ophthalmology, dental practice etc. opening new possibilities for treatment both humans and animals. Late decades have demonstrated a search for new materials suitable for implantation into living organism and development of universal techniques for repair of living tissue defects.
The particular attention is paid to titanium which has taken the leading position in transplantology because of its’ unique technical characteristics. Thus combination of biological indifference, chemical stability and high mechanical strength have made titanium and its’ alloys practically an indispensable material in repairing large segments of musculoskeletal system. That’s why now days a great attention is paid to the process of working out of new constructions made of titanium in accordance with particular biological and clinical problems. In this paper implant properties of meshes made of titanium VT -1.00 are studied. Meshes are chosen because they can be fixed and integrated into the living tissues enchasing the strength of newly born connective tissue due to reinforcement.
Materials and methods. Meshes were produced of titanium wire VT-1.00, 100 mkm thread, size 2-3 cm, cells of 1.0-2.0 mm diameter. The meshes were implanted under the sterile conditions to 12 animals (8 dogs at the age of 4 months- 5 years and 4 rabbits) at the point of defects in muscle – aponeurotic layer of the abdominal wall. Animals were followed up for 12 months after operations. General clinical studies were conducted together with hematological and immunological control. The maximum follow up time was 1 year and 3 months. During the follow up period with the intervals of 2 weeks, 1, 3,6,12 months there were conducted several investigations: tissue observation in the area of implantation, biopsy with histological examination and scanning electron microscopy of samples taken.
Results. General condition of experimental animals was not affected during the experiment. They had the same appetite, weight and waterworks. Wound healing in all cases was done by primary tension. Time of serous exudates removal from the wound was 3 days. Infiltration in the area of postoperative wound during first 3-5 days was without hyperemia, hyperthermia and suppuration. By the end of 10-14th days infiltration disappeared and wound healing went according the primary tension (stretching). Non complicated postoperative out come can be seen even in negative animal behavior and scar licking by the animals. This fact proves the implant stability to the infection. Beginning with the 10th day natural implant fixation to the abdominal wall tissues is strong enough and implant or mesh offset is impossible. Among local wound changes there was noted infiltration of tissues surrounding the implant area up to 7-10 days. Rejection reactions were not noted.
Histological and microscopic examinations support uncomplicated character of primary wound healing process and new tissue formation process in the zone of the implant. Inflammatory changes characteristic for tissue reaction to the foreign body implantation are mild and not purulent. In the same way as with other biocompatible implants the inflammatory reaction subsided to the time of 2 weeks. The explicit circular fouling of the implant with the connective tissue was observed. At the points of rough metal surface collagen fibers were firmly fixed to the construction elements. On the smooth areas a thin layer of connective tissue capsule was formed.
In later periods –from 4 weeks to 1 year- no clinical wound or general complications connected with titaniumVT-1.00 implantation were observed. Scar condition was normal not regarding the way of implantation (onlay or sublay). There was noted no sign of suppuration, rejection or fistulas. In the later period morphological changes and formation of fiber tissue could be seen. This fiber tissue grew through 3 D construction of titanium mesh. Architectonic of the tissue is according to the metal implant structure. Chronic inflammation signs were not present.
Conclusion. Biocompatibility of Titanium VT-1.00 as an implant material is proved in the short and long term postoperative period. Wire mesh construction provides good integrative properties and strength of the “connective tissue implant” complex in the treatment of muscular aponeurotic layer of soft tissue defect. Fixation degree provides particular stability of this material to infection. Due to it titanium VT-1.00 can be used as material suitable for implantation under the condition of infection presence.
- Wire mesh constructions made of Titanium VT -1.00 have high implant properties; they are biologically indifferent and easily integrative with connective tissue of the organism.
- Integration degree of those transplants depends on structure of implant material surface.
- Titanium VT -1.00 meshes can used in reconstructive and plastic human and veterinarian surgery.