ABSTRACT
El objetivo de la presente investigación fue el realizar un análisis de impacto presupuestario del injerto óseo en un servicio regional de salud chileno en base a un banco de tejido óseo. Se realizó un estudio epidemiológico preliminar para obtener los datos necesarios para el análisis, específicamente sobre procedimientos de injerto óseo en un servicio de salud local del Servicio Salud Concepción (SSC). Esta búsqueda evidenció un total de 6.252 cc de injertos óseos con un costo total de USD $156.000 por año. Se encontró una capacidad potencial de 302 ± 16 cabezas femorales recuperadas por año de los procedimientos de reemplazo total de cadera y que un banco de tejido óseo puede generar un ahorro de USD $145.000 en los costos hospitalarios por año. Este análisis evidenció que en un servicio de salud representativo de Chile existe una dependencia de sustitutos óseos importados y autoinjertos que pueden ser suplidos de manera sustentable con un banco de tejido óseo basado en donaciones de cabezas femorales bajo la legislación vigente de la autoridad sanitaria chilena.
This research aimed to analyze the costs of bone grafting through a bone tissue bank in a Chilean regional health service. Methods: First, we developed a preliminary epidemiological study to obtain the necessary data for the analysis, specifically on bone graft procedures in a local health service (Servicio Salud Concepción). Next, we performed a budget impact analysis. Results: We analyzed a total of 6,252 cc of bone grafts, with a total cost of USD$156,000 per year. We found a potential recovering capacity of 302 ± 16 femoral heads per year from the total hip replacement procedures. Based on these results, bone tissue banks could save USD$145,000 hospital costs annually. Studying a representative health service from Chile, this analysis revealed a dependency on imported bone substitutes and autografts. These requirements can be supplied sustainably by a bone tissue bank based on donations of femoral heads under the current legislation of the Chilean health authority.
ABSTRACT
This research aimed to analyze the costs of bone grafting through a bone tissue bank in a Chilean regional health service. Methods: First, we developed a preliminary epidemiological study to obtain the necessary data for the analysis, specifically on bone graft procedures in a local health service (Servicio Salud Concepción). Next, we performed a budget impact analysis. Results: We analyzed a total of 6,252 cc of bone grafts, with a total cost of USD$156,000 per year. We found a potential recovering capacity of 302 ± 16 femoral heads per year from the total hip replacement procedures. Based on these results, bone tissue banks could save USD$145,000 hospital costs annually. Studying a representative health service from Chile, this analysis revealed a dependency on imported bone substitutes and autografts. These requirements can be supplied sustainably by a bone tissue bank based on donations of femoral heads under the current legislation of the Chilean health authority.
Subject(s)
Bone Banks , Bone Transplantation , Humans , Chile , Bone Transplantation/methods , Arthroplasty, Replacement, Hip/statistics & numerical data , Budgets , Middle Aged , Female , MaleABSTRACT
The transplantation of tissues can save lives and re-establish vital functions, where no alternatives of comparable effectiveness exist. This has led to establishment of tissue transplantation as a successful practice worldwide; however, a great variability between countries remains in terms of donation levels, safety, quality of grafts and their efficacy. Tissue transplantation requires coordination of different agencies involved in the implementation of procurement, processing, storage and distribution of tissues and cells from different hospital units that perform surgical procedures with graft-type input requirements. This biomaterial-like requirement has led to the constant development of the area and today these graft products of human origin can be the starting point for new and more advanced biotechnological products. For long-term sustainability and successful transplantation units, a process management comparable to the pharmaceutical industry in terms of quality management systems must be established to produce safe and high-quality human-derived products. This review aims to update the current concepts of tissue transplant services for its application for developing countries using the current Chilean scenario as a case study. We summarize our findings proposing a set of guidelines/actions that should be followed to ensure smooth tissue transplant services implementations with high efficiency and safe use.
Subject(s)
Tissue and Organ Procurement , Transplants , Developing Countries , HumansABSTRACT
Objetivo. Realizar un estudio descriptivo y retrospectivo para analizar el éxito de la rehabilitación dentaria con o sin aumento óseo alveolar. Materiales y métodos. Se realizó un estudio retrospectivo mediante la revisión de historias clínicas de pacientes que concurrieron al Servicio de Cirugía Máxilofacial del Hospital Clínico Mutual de Seguridad, Chile, en el período de 3 años (enero 2003 - diciembre 2005). Resultados. Un total de 135 pacientes ingresaron al estudio en los cuales se instalaron 246 implantes dentales. Se registraron 8 pérdidas de implantes en el seguimiento. Conclusiones. En este estudio se presenta un protocolo establecido y se establece la necesidad de un diagnóstico detallado para planificar la rehabilitación mediante implantes dentales posterior a un trauma con un equipo multidisciplinario (AU)
Objectives. Conduct a retrospective study to analyse the success of dental implant treatment with or without bone ridge augmentation. Materials and methods. A retrospective study was made by reviewing medical records of patients who attended the Maxillofacial Surgery Service of Hospital Mutual de Seguridad, Chile. In the period of three years (January 2003 - December 2005). Results. There were a total of 135 patients with 246 dental implants indications. 8 cases with dental implant loss where registered. Conclusions. This study presents a proposal protocol, and establishes the need of a detail diagnosis to design the post-traumatic implant rehabilitation treatment with a multidisciplinary team (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Dental Implants/trends , Dental Implants , Bone Regeneration/physiology , Guided Tissue Regeneration/trends , Guided Tissue Regeneration , Tooth Fractures/surgery , Tooth Fractures , Allografts/surgery , Retrospective Studies , Vestibular Nerve/injuriesABSTRACT
Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition, caused by hematic bacterial migration or direct migration of other head and neck infections. We report a 41 year old female who presented a right temporomandibular joint involvement, with bone destruction of the mandibular condyle and an infectious process spreading to the temporal space, following a necrotizing medial and external otitis with associated mastoiditis. A septic arthritis of the TMJ by continuity was diagnosed and treated with antimicrobials, TMJ arthrocentesis and occlusal stabilization, with a positive evolution. However, the patient remains in control due a secondary TMJ osteoarthritis caused by the septic arthritis.
Subject(s)
Arthritis, Infectious/complications , Temporomandibular Joint Disorders/etiology , Adult , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Female , Humans , Mastoiditis/etiology , Temporomandibular Joint Disorders/surgery , Tomography, X-Ray Computed , Tooth ExtractionABSTRACT
Objectives: Collect maxillofacial trauma data, specifically in orbital reconstruction, in adult patients to make an evaluation of the clinical results. Material and Methods: Reviewing medical records in a three years period (January 2009-December 2011), of patients with orbital fracture reconstruction who attended the Maxillofacial Surgery Service of Hospital Mutual de Seguridad, Chile, in a retrospective study. Results: There where a total of 87 patients with 88 orbital fractures diagnosis, 30 patients go to orbital reconstruction with orbital titanium mesh. The most common cause where accidents and violence traffic. It was observed a 6.7 percent of complications. Discussion: The orbital fracture pattern and the results cause diplopia as the main complication. Furthermore, we can conclude that the orbital titanium mesh is an effective material and allows a well adaptation and lower complications.
Objetivo: Obtener información del trauma maxilofacial, específicamente de la reconstrucción orbitaria, en pacientes adultos para la evaluación de sus resultados clínicos. Materiales y Métodos: Se realizó un estudio descriptivo retrospectivo en todos los casos de fracturas orbitarias que asistieron al servicio de cirugía maxilofacial del hospital clínico Mutual de Seguridad de Santiago de Chile. En el período de 3 años (enero de 2009-diciembre de 2011). La necesidad de reconstrucción fue el criterio de inclusión. Resultados: Se registraron 87 pacientes con 88 diagnósticos de fracturas orbitarias, de estos, 30 pacientes debieron someterse a reconstrucción orbitaria mediante malla de titanio. Las causas más comunes fueron el accidente de tránsito 34 por ciento y las agresiones 30 por ciento. Se observó una tasa de complicaciones de 6,7 por ciento. Discusión: El patrón de fractura orbitaria observado y nuestros resultados muestran a la diplopía como principal complicación, además podemos señalar que las mallas de titanio son un material eficaz que permite una apropiada adaptación y bajas complicaciones.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Orbital Fractures/surgery , Plastic Surgery Procedures , Surgical Mesh , Titanium , Retrospective Studies , Treatment OutcomeABSTRACT
Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition, caused by hematic bacterial migration or direct migration of other head and neck infections. We report a 41 year old female who presented a right temporomandibular joint involvement, with bone destruction of the mandibular condyle and an infectious process spreading to the temporal space, following a necrotizing medial and external otitis with associated mastoiditis. A septic arthritis of the TMJ by continuity was diagnosed and treated with antimicrobials, TMJ arthrocentesis and occlusal stabilization, with a positive evolution. However, the patient remains in control due a secondary TMJ osteoarthritis caused by the septic arthritis.
Subject(s)
Adult , Female , Humans , Arthritis, Infectious/complications , Temporomandibular Joint Disorders/etiology , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Mastoiditis/etiology , Temporomandibular Joint Disorders/surgery , Tomography, X-Ray Computed , Tooth ExtractionABSTRACT
Objetivo: Recopilar información del traumatismo maxilofacial, específicamente en pacientes adultos, en el periodo de 3 años en un centro chileno de referencia de traumatismos. Materiales y métodos: Se realizó un estudio descriptivo retrospectivo en todos los casos de fracturas faciales que asistieron al Servicio de Cirugía Maxilofacial del Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago de Chile, en el periodo de 3 años (enero de 2009-diciembre de 2011). Fueron analizadas las variables y distribución de género, edad, tipo, frecuencia de cada fractura y causa del traumatismo. Resultados: La población estudiada consistió en 283 pacientes, 259 (91,5%) hombres y 24 (8,5%) mujeres con un promedio de edad de 40,5 (SD: ± 20,5) años. En 499 sitios de fractura las fracturas cigomáticas fueron la localización más prevalente en ambos géneros (48%), seguidas de las fracturas orbitarias (27,2%) y en tercer lugar las fracturas mandibulares (21,2%). La parte de la cara más afectada fue el tercio medio. Los traumatismos por accidente de tránsito fueron la causa más común (39,2%); la gran mayoría de estos fueron por accidente automovilístico. Discusión: Los resultados mostrados en este artículo están en línea con la literatura, y el análisis de este reporte provee importante información para el diseño de planes de prevención de riesgos, especialmente para desarrollar medidas en el área del tránsito (AU)
Objectives: The aim of the present descriptive study was to record data on maxillofacial trauma in working adults in a 3 year-period in a reference trauma center in Chile. Materials and methods: A descriptive study was conducted on cases of maxillofacial fractures treated in the Maxillofacial Surgery Unit of the Hospital Clínico Mutual de Seguridad, Santiago de Chile, over a 3-year period. Frequency, type and cause of injury, as well as age and gender distribution were analyzed. Results: The study population consisted of 283 patients, 259 (91.5%) males and 24 (8.5%) females with a mean age of 40.5 (SD: ± 20.5) years. In 499 fracture sites Zygomatic fractures were the most prevalent location of the 499 fracture sites, in both males and females (48%), followed by orbital fractures (27.2%), and jaw fractures (21.2%). The most common affected part of the face was isolated mid-facial fractures. Traffic-accident-related fractures were the most common cause (39.2%), with the largest proportion of these involving a car accident. Discussion: The results presented are in line with other studies and the analysis of this report provides important data for the design of plans for injury prevention, especially for measures in road traffic (AU)
