RESUMO
Many forms of banked bone allograft are available to the surgeon. Among the grafts available are fresh, fresh-frozen, freeze-dried, and demineralized bone. Each one of these grafts carries risks and has unique limitations and handling properties. In order to use these materials appropriately, the surgeon must be familiar with the properties of each and must feel confident that the bone bank providing the graft is supplying a safe and sterile graft. In the future, allograft bone will become obsolete. In place of banked bone, surgeons will use synthetically produced bone morphogenic protein that has been incorporated into an absorbable matrix. These materials will exist in a time-release form that will allow the graft material to grow and mature with the patient. Until this goal is achieved and is available clinically, surgeons must be familiar with the capabilities and limitations of banked bone graft.
Assuntos
Bancos de Ossos , Cirurgia Plástica , Técnica de Desmineralização Óssea , Transplante Ósseo/imunologia , Transmissão de Doença Infecciosa/prevenção & controle , Histocompatibilidade , Humanos , Doadores de TecidosRESUMO
Low-molecular-weight dextran is utilized by many microsurgeons after free tissue transfer for its beneficial effects on the microcirculation. While it is generally felt to have a low rate of complications, severe complications secondary to dextran's osmotic effects may occur. We report here on two cases in which therapy with low-molecular-weight dextran was strongly implicated as a causative factor in major complications. These cases and their background are reviewed. Guidelines for the safe administration of this agent in patients post free-tissue transfer are discussed.
Assuntos
Dextranos/efeitos adversos , Pé/cirurgia , Músculos/transplante , Retalhos Cirúrgicos , Injúria Renal Aguda/induzido quimicamente , Adolescente , Dextranos/administração & dosagem , Feminino , Humanos , Hiperpotassemia/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Peso Molecular , Osmose , Pseudotumor Cerebral/induzido quimicamente , Retalhos Cirúrgicos/métodosRESUMO
The nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used analgesics associated with a significant incidence of gastritis and/or peptic ulceration. This study was designed to evaluate the efficacy of sucralfate (SC) in reducing NSAID-induced ulceration in a rat model. Nine groups of 20 rats each were segregated by drug(s) tested. Two NSAIDs, aspirin (ASA) and indomethacin (IND), were tested. Control groups consisted of saline only, ASA only, and IND only. SC was tested against ASA and IND separately, being administered 5 minutes preceding, mixed with, or 5 minutes following each NSAID. Administration of SC before ASA resulted in a reduction of mean ulcers per rat from 10.4 +/- 4.3 to 1.1 +/- 1.3 (P less than or equal to .0001). Administration of SC prior to IND resulted in a reduction of mean ulcer rate from 6.6 +/- 5.4 to 3.0 +/- 3.3 (P less than or equal to .02). When SC was given with IND or following it, no reduction in ulcer rate was observed. When SC was given with ASA or following it, the ulcer rate was reduced to 5.3 +/- 3.0 (P less than or equal to .002). It is concluded that SC is effective in reducing NSAID-induced ulcer production especially when administered before NSAID ingestion.