The impact of the dibutyrylchitin molar mass on the bioactive properties of dressings used to treat soft tissue wounds.

In this work, we describe a novel technique for producing biocompatible medical products with bioactive properties from the biodegradable polymer dibutyrylchitin (DBC). Materials produced by blowing out polymer solutions have excellent hemostaic properties and are easy to handle during surgery. Biocompatibility studies, encompassing hemostasis and the evaluation of post-implantation reactions, indicate that the biological properties of DBC depend on the molecular mass of the polymer. Lower molecular mass polymers are preferable for use in implanted wound dressings.

Early histological evaluation of bone defect healing with and without guided bone regeneration techniques: experimental animal studies.

INTRODUCTIONS: To obtain osseous tissue regeneration, treatment methods referred to as guided bone regeneration are used which utilize the mechanical, chemical, and biological properties of materials. MATERIAL/METHODS: Eighteen white rabbits were used. Under general anesthesia, a 5 mm in diameter defect was created transcutaneously in the femur trochanter major. The rabbits were divided into three groups depending on the type of the intraosseous defect (ID) treatment: in group I (C) the control IDs were left to heal spontaneously, in II (BOC+BG) the IDs were filled with Bio-Oss Collagen and Bio Gide Perio membrane, and in III (PRP) the IDs were filled with BOC and platelet-rich plasma (Curasan Centrifuge). The animals were sacrificed 1 and 3 months after the surgical procedure. The histological material was stained with hematoxylin and eosin and using the van Gieson method. RESULTS AND CONCLUSIONS: In the earlier histological examinations (1 and 3 months after the procedures), resorption of the biomaterial and the formation of new bone trabeculas were observed in both groups II and III. At the first observation the extent of biomaterial resorption and the intensity of the osteogenic process were greater in group III, but after 3 months group II had a slight advantage. Fragmented remnants of the biomaterial in both groups were surrounded by newly formed bone and locally by fibrous connective tissue. At both observation times the number of bone trabeculas after implantation in groups II and III was greater than in the control group.

Evaluation of the dynamics of sensory improvement in the hand after surgical treatment of carpal tunnel syndrome.

BACKGROUND AND PURPOSE: The aim of the study was to evaluate the dynamics of improvement of tactile sensory threshold and two-point discrimination in fingers innervated by the median nerve after surgical treatment of carpal tunnel syndrome (CTS), to assess differences between improvements of both aforementioned sensory measures, as well as to estimate the time taken to achieve ultimate sensory improvement in the hand. MATERIAL AND METHODS: The study included 87 patients (78 females and 9 males) operated on at the Department of Traumatology and Hand Surgery, Medical Academy in Wroclaw between July 2002 and August 2004 because of carpal tunnel syndrome. Mean age of patients was 51.8 years. The study included evaluation of tactile sensory (pressure) threshold and two-point discrimination. Measurements were performed seven times in each patient, that is, before the surgery, and then on the second, fifth and tenth postoperative day as well as one, three and six months after the surgery. RESULTS: There were only minor differences in improvement of tactile sensory threshold and two-point discrimination between particular fingers, but in each case less favourable results were achieved in the thumb and the middle finger and the best results in the ring finger. Over time the observed degree of sensory improvement decreased, and during the last follow-up mean values of tactile sensory threshold and two-point discrimination in each of the studied fingers were within the normal range. CONCLUSIONS: After surgical treatment of CTS normalisation of two-point discrimination occurs earlier than normalisation of tactile sensory threshold. The highest degree of improvement of two-point discrimination is observed during the first two days after surgery, while the highest degree of improvement of tactile sensory threshold is noted between the 10th and 30th postoperative day. No further significant improvement of tactile sensory threshold or two-point discrimination is observed following an initial period of three months after surgery.

[Application of elemental microanalysis for estimation of osteoinduction and osteoconduction of hydroxyapatite bone implants]. / Zastosowanie mikroanalizy pierwiastkowej do oceny osteoindukcji i osteokondukcji dokostnych implantów hydroksyapatytowych.

Hydroxyapatite (HAp) ceramics based on calcium phosphates, chemical compounds being natural constructive element of bones is now regarded to be one of better implantation materials in osseous surgery and stomatology. HAp is poorly soluble and slowly resorbing in tissues material. Easiness of connecting of hydroxyapatite ceramics with other materials creates possibilities to produce new composites of chemical compounds containing calcium and easier resorbing. An important and till now not fully known problem is influence of hydrodroxyapatite grafts on the processes leading to production of calcium and phosphorus ions responsive for mineralization of bone tissue around the graft. Proliferation of osteoblasts and rate of osseous trabeculas production depends, among others, concentration of calcium and phosphorus ions. The main target of this study was the comparative analysis of the bone mineralisation rate after implantation of hydroxyapatite (HAp) and composites hydroxyapatite + beta tricalcium phosphate (HAp + TCP) and hydroxyapatite + calcium hydrosulfate (HAp + gypsum), on the basis of elemental microanalysis. Implantation studies were carried out on 24 rabbits. Sections were carried out 5, 9, 11 and 14 weeks after implantation of the tested materials. The carried out punctual analysis of the occurring elements and their topographic location (mapping) in bones after implantation showed essential differences among the tested grafts. Those differences were most significant after 5 and 14 weeks and depended on the rate of the tested materials resorption. On the basis of conducted macroscopic evaluation and scanning microscope assessment we can stated that the composite of HAp+TCP showed the best osteocunductive properties, while the best osteoinductive influence was shown by the composite HAp + gypsum.

[The effect of polyester vascular prostheses on synthesis TNF-alpha, IFN-gamma and NO by human peripheral blood leukocytes--in vitro]. / Wplyw poliestrowych protez naczyniowych na synteze TNF-alpha, IFN-gamma oraz NO przez ludzkie leukocyty krwi obwodowej--in vitro.

Vascular prostheses produced on the basis of polyester are today commonly used in vascular surgery. To improve their biofuncionality special technologies are used, among them double knit and hydrophile feature enrichment. These modifications could cause the local activation of leukocytes to produce the mediators of inflammatory reaction, which in turn leads to hyperplasia of endothelium and other dangerous complications. In our study we used two kinds of polyester prostheses: double velour knitted hydrophilic Dallon H and standard double velour knitted prosthesis Dallon as control. The aim of this work was to compare in vitro the levels of cytokines TNF-alpha, interferon (IFN) and nitric oxide (NO) found in the supernatants of human blood leukocyte cultures after stimulation by both these above-mentioned vascular prostheses materials which are designed for use in direct blood contact. Tested implant materials Dallon H had no influence on synthesis of production of IFN, TNF-alpha and NO by human blood leukocytes. These results allow to made the initial selection of biomaterials before their in vivo evaluation.

[Effect of corundum-vancomycin composite on soft tissue reaction]. / Wplyw kompozytu korundowego z Wankomycyna na odczyn tkanek miekkich.

The ceramics on the basis of corundum is used for implantation in the form of porous and solid materials. The solid form was used to produce tissue endoprosthesis while porous form is mainly used to fill in the bone defects. The corundum ceramics are also known to be used as coatings for implants in orthopedics and dentistry. On the other hand there is still a need to find out the new way of treatment of the chronic bone infection, during which the traditional way of antibiotics therapy is no more effective. One of the possibly solution is to use the different biomaterials as drug carriers and in the bone surgery one of the best are porous corundum implants, being themselves of high biocompatibility, and additionally containing Vancomycin. The main target of the investigation presented in this paper was the comparative assessment of the corundum ceramics and its composite containing Vancomycin after implantation into back muscle of the total of 15 rats. During the post mortem macroscopic assessment in the tissues which surrounded the implants there were no any inflammatory neither pathological changes observed. In the microscopic findings, in early periods, the observed inflammatory tissue reaction for implants with vancomycin was significantly greater what could be explained by the high concentration of the antibiotic in the given material. On the basis of the results of macroscopic and microscopic findings we can state that the composite material of corundum ceramic containing vancomycin is of high compatibility and could be regarded as the good drug carrier.

[The bone reaction to the implantation of the corundum-vancomycin composite]. / Reakcja tkanki kostnej po implantacji ceramiki korundowej z Wankomycyna.

Polymethacrylate methylene (PMMA) used as the carrier for antibiotic gentamycin (Septopal) shows today very limited effectiveness. Only 24% of the staphylococcus strains is still susceptible for it. In 1982 this factor was as high as 97%! Because of the growing resistance of different strains of staphylococcus, enterococcus and G(-) bacillus for antibiotics in present use, came into being the necessity for evaluation of the state-of-the-art antibiotic carrier of the new generation, which should be effective to destroy the resistant strains of bacteria. The porous corundum ceramics proved to be good material for this purpose, specially in use for bone surgery. During the laboratory tests it was confirmed that corundum ceramics could be soaked with the different antibiotics of the new generations. The bacteriological tests proved that corundum ceramics soaked with the Vancomycin show the highest possibly antibacterial activity. On the basis of those results we undertook the implantation test on animals. The implantation was carried out on 10 rabbits in which the samples of tested ceramic with Vancomycin were implanted into femoral bone. The investigation periods were set up for 1, 3, 6 and 9 months. On the basis of received results of macroscopic, microscopic and radiological findings we can stated that corundum ceramic with Vancomycin can be used in the treatment of bone infections.

[Clinical applications of peripheral nerve allotransplantation. Present medical experience and review of the literature]. / Kliniczne zastosowanie wszczepów nerwów pobranych ze zwlok. Obecny stan wiedzy i przeglad pismiennictwa.

Nerve autograft has become recently the gold standard for the reconstruction of surgical nerve gap. Functional results of using this technique continue to improve with the advances in micro-neurosurgery and with greater understanding of neurobiology and nerve regeneration. Surgical reconstruction of extensive nerve injuries frequently exhausts the patient's own source of expandable autogenous nerve grafts. Nerve allografts would offer a limitless supply of graft material. The requirement of only transient immunosuppression to support the regeneration of host axons across the nerve allograft toward distal host receptors renders the nerve allograft an advantageous option for these otherwise irreparable nerve injuries. The methods of graft harvesting, preservation and patients' immunosuppressive regimen as well as the clinical outcomes following the nerve allotransplantation are discussed.

[Tissue reaction after implantation of ceramic biomaterials with introduced electrokinetic zeta potential on surface]. / Odczyn tkankowy po implantacji biomaterialów ceramicznych z wprowadzonym na powierzchnie potencjalem elektrokinetycznym zeta.

Studies over implants showed, that not only the kind of structure of material, but also the character of surface influences the local reaction. Endeavour to obtain the best possible biological properties of implants, intended to supplementing of osseous decreases, contributed to carrying out investigations over implants about active surface. Electrochemical reactions, occurring on implants surface, lead to beginning of electric occurrences on implant/tissue interface and beginning of so-called potential zeta. Utilization of these properties in implantology, induced us to carry out experimental studies with use of biomaterials with modified surface and of influence of potential zeta on biocompatibility. The carried out studies referred: to comparative investigations of tissue reaction of implants ceramic with of solid and porous surface, and to influence of electric load zeta on tissue reaction. For the studies were used 3 kinds of ceramics: porous, solid and solid ceramics with potential zeta (silanovated). The studies were carried out on 50 rats, to which studied ceramics was implanted into back muscles. Pathomorphological assessments were carried out 1, 4, 12, 26 and 32 weeks after implantation. The results of pathomorphological studies after implantation of ceramics solid and solid silanovated showed, that already after 1 week was formed thin membrane with visible, small blood-vessels. After 32 weeks it was significantly thicker. The produced capsule was strongly connected with surrounding muscles, and from side the implant adhered to it's surface. In case of implants of porous ceramics, already after 1 week the produced capsule of connective tissue was clearly thicker, and after 32 weeks it was, whitish, opaque, strongly connected to surrounding muscles. From side implant it became rooted in pores of ceramics. In microscopic studies it was shown, that both in early and distant period, the character and size of tissue reaction was dependent on structures of implant surface. Porous ceramics implanted in soft tissues, produced stronger inflammatory reaction being characterized with long lasting phase infiltration, which drove to producing thick connective tissue capsule. 32 weeks after implantation in the produced capsule these were visible former focuses of chondroid tissue. Reaction tissue occurring round solid ceramics, was characterized with shorter and less intensive proliferation phase. After 32 weeks visible former thin connective tissue capsule was visible. Ceramics with potential zeta (silanovated) generated minimum-tissue reaction, without visible proliferation phase. Studies in light and scanning microscopes, executed 32 weeks after implantation showed, that in produced thin layer of connective tissue were visible with adamantinating and calcifications focuses, and on the surface of ceramics were formed osseous tin plates.

[Investigation of local reaction of muscular tissue after injection of polyvinylpyrrolidone preparation]. / Badania miejscowej reakcji tkanki miesniowej po iniekcji preparatu poliwinylopirolidonu.

Natural preparations for replenishing of hyaluronic acid of zoogenous origin used till now, are characterized with quit low biocompatibility and also too short effect of their action. Recently worked out synthetic polyvinylpyrrolidone preparation PVP, contains modification constituting internally netting of microgels to improve polymer bioresistance. The introduce modification can, however influence PVP biocompatibility after deposition into tissues of the living organism. The aim of research was evaluation of the local reaction of muscular tissue after PVP infection. The results of research concerned a control group where normal saline was used for infections. The research was carried out on 18 Wistar rats and included macroscopic and histologic observations made in the 3rd, 5th, 7th, 14th and 30th day after PVP injection into thigh muscle. The local reaction of muscular tissue was macroscopically characterized with inflammatory reaction till the 7th day after PVP injection, in later terms the observed changes disappeared. Microscopic research showed that PVP till the 7th day after PVP injection caused rather strong diffuse non-specific inflammatory process, yet without essential participation of neutrophils leading to producing of loose intra-muscular. Connective tissue in a later term. The carried out tests showed presence of PVP in muscular tissue till the 30th day after injection.

[Tissue reaction after injection of polyvinylpyrrolidone (PVP) preparation into knee joint. Experiment]. / Odczyn tkankowy po iniekcji preparatu poliwinylopirolidonu (PVP) do stawu kolanowego. Badania doswiadczalne.

Internally netted miscogelatinated preparation on the basis of polyvinylpyrrolidone PVP desioned for viscosuplementation of joint fluid was worked out. Netted structure of microgel grains presents larger resistance to the degrading action of free radicals than analogical linear polymer chains. Application of zoogeous preparations of hyaluronic acid results in short-term effects of their usage in evoking reaction foreign protein. Replenishment of joint fluid with preparation with higher biostability from biocompatible synthetic polymer-polyvinylpyrrolidone could improve the function of synovial through restoration of its proper viscosity and protection of the joint for a longer period of time. The aim of the experiment was determination of bioresistance and reaction of microgel PVP on the tissues of synovial joint. The tests were carried out on 10 white New Zealand rabbits after injection PVP into the knee joint for 3, 7, 14 and 30 days and submitted to macroscopic and histological evaluation. The results of tests were compared with the data obtained after injection of normal saline. Macroscopically, there were no changes in the limits of articular capsule and cartilage; there was only slight and enlargement of synovial membrane in the first 7 days after PVP injection. In histological tests it was observed that reaction in the knee joint after PVP injection was characterised it single inflammatory chains without essential participation of neutrophils observed only in synovial membrane and limited to places were tested preparation was seen. Microgel PVP was present in diverticula of synovial membrane to 30th day after injection.

[Investigation of biocompatibility of the apatite cement]. / Badanie biozgodnosci cementu apatytowego.

The results of experimental studies of biocompatibility of the apatite cement, implanted in the muscular tissue of rats and bone tissue of rabbits were presented in this study. Investigations of the local reactions of the muscular tissue were carried out on 18 rats of Wistar type by implanting samples from the apatite cement in the dorsal muscles. Macroscopic and microscopic investigations were carried out 7, 14, 30, 180, 270 days after the implantation. Investigations of local reactions of bone tissue were carried out on 12 rabbits of New Zealand breed. By implanting the tested material into the femoral bone in the region of trochanter. Sections of the animals were made 1, 3, 6, and 9 months after the surgery. In the early period active inflammatory process was seen in the muscles in the direct vicinity of the implant and then it disappeared leading to formation of a thin fibrous connective tissue capsule. Histological investigations made of bone tissue later showed, formation of young tissue with small focuses of fibrous connective tissue. In the carried out investigations it was shown that the apatite cement is characterized with a high degree of biocompatibility and osteoinductive activity.

[Investigation of tissue reaction of apatite cement implants impregnated with vancomycin]. / Badanie odczynu tkankowego na wszczepy cementu apatytowego zawierajacego wankomycyne.

Investigation of biocompatibility degree of apatite cement as a carrier of antibiotic--vancomycin was the purpose of the experimental study. Investigation of local reactions of muscular tissue was carried out on 18 rats of Wistar type, by implanting samples of apatite cement with vancomycin in the dorsal muscles. Sections of the animals and microscopic investigations were made 7, 14, 30, 90, 180 and 270 days after the implantation. Investigation of local reactions of bone tissue were carried out on 12 rabbits of New Zealand breed, by implanting the investigated samples into the femoral bone in the region of trochanter. Macroscopic, radiological and microscopic investigations were carried out 1, 3, 6 and 9 months after the surgery. The obtained results of the investigations from muscular and bone tissue, were compared to the investigations in analogical tissues of apatite cement without the medication. In macro- and microscopic investigations in the early period inflammatory reaction of muscles was noticed to be stronger around the samples with vancomycin, in comparison to the control implant. In the later period there was no inflammatory reaction and a thin fibrous connective tissue surrounded the implant and a histological picture was similar, as in cases of an implant without the antibiotic. The local reaction of bone tissue both in the control and in the investigated group (apatite cement with vancomycin) was similar. In the early period the proliferation of rich cellular connective tissue, was noticed. In the later period starting from the 3rd month, formation of young bone tissue was noticed and only locally there were focuses of fibrous tissue. The process observed after splitting of the tested materials into bone tissue, was very similar to healing processes after long bone fraction. The carried out investigations showed, that tissue reaction after implantation of apatite cement and its composite with vancomycin, was very similar and showed a high degree of tissue biocompatibility.

[Comparative evaluation of TNF-alpha induction in vitro and in local tissue reaction after implantation of HAP/TCP and HAP]. / Badania porównawcze indukcji TNF-alpha in vitro i miejscowej reakcji tkanek po implantacji HAP/TCP i HAP.

The aim of this work was the evaluation of biocompatibility and bioactivity of HAP/TCP as compared to HAP. This evaluation was carried out by the in vitro assessment of the induction of TNF-alpha in the rat blood after the contact with the tested HAP. The anther target was to investigate of local muscle tissue reaction of rats bones reaction of rabbits, after the implantation of tested materials. The level of TNF-alpha was estimated by biological method in the supernatants of rat blood cell cultures stimulated in vitro by tested materials. The implantation assessment was carried out on 25 rats and 15 rabbits. The muscle tissue reaction was evaluated after 2, 4, 8, 12, and 24 weeks, while the reaction of bones after 4, 12, and 26 weeks since the implantation. The level of TNF-alpha in the blood after stimulation in vitro with HAP/TCP was on the same level as control group. The implantation of HAP the level of TNF-alpha was twice as high as compared to HAP/TCP and control groups. These differences were of statically importance. The muscle tissue reaction after implantation of HAP/TCP was characterized by moderate inflammation during the early period which lead to the formation of two layer connective tissue capsule. In the capsule wall there were great cells of foreign body type and macrophages. In the cytoplasm of some the cells particles of HAP were noted, what could be regarded as the proof of its resorption. In the bone tissue surrounded HAP/TCP implants the stronger osteoconductive proprieties were observed as compared to the tissue around HAP.

Tissue reaction after implantation of Spongostan, as the carrier of xenogenic bone morphogenetic protein. Experimental study.

Reconstruction or filling of bone defects, especially in the maxillofacial region, often requires use of biomaterials. An implant should fasten healing of the bone gap or it should replace autogenic bone grafts. The combination of bone morphogenetic proteins with suitable carrier may fulfill these requirements. Proteins causing differentiation of mesenchymal cells in chondroblasts and osteoblasts were called Bone Morphogenetic Proteins--BMPs. The authors extracted BMP from bovine bones and placed it into collagen carrier formed from generally accessible hemostatic sponge--Spongostan. The implants were grafted into rat femoral muscle pouches in order to trace the tissue response. Pathologic examinations were performed 3, 6 and 8 weeks after implantation. On the basis on macroscopic and microscopic examinations it was stated that collagen sponge speckled with BMP caused minimal tissue response and evolved characteristic thin connective tissue capsule formation around the implant. The connective tissue penetrated spongious structure of the implant, filling the spaces, which became growing due to sponge resorption. Characteristic hyalinization and sparse chondroblasts were visible 8 weeks after implantation.

Tissue reaction following the implantation of a DALLON H vascular prosthesis in the thoracic aorta defect. Experimental tests.

Vascular prostheses made of polyester or polytetrafluoroethylene fibres are most frequently used nowadays. Woven polyester prostheses are sealed following the suturing in the circulatory system, but they cause a tissue reaction. Knitted polyesters grafts cause a lesser tissue reaction, but demand intraoperative sealing. Thus numerous tests to improve them are conducted. TRICOMED S.A. (Poland) has modified the company's own double velour knitted vascular prosthesis. The graft's physical and chemical features have been changed and hydrophilia has been used, due to which dripping the graft takes little blood and its tightness is achieved in a dozen or so seconds. The evaluation of surgical qualities as well as the healing-in process of the modified knitted hydrophilic prosthesis DALLON H has been conducted at the Department of Experimental Surgery and Biomaterials of Wroclaw Medical University. DALLON H prosthesis was compared to DALLON, a standard double velour knitted prosthesis. The tests were performed on 16 Polish breed piglets with 25-35 kg of weight and 2.5 months of age. Two follow-up periods of 3 and 6 months were established following the surgeries. In each group six piglets had a 6-cm-long segment of DALLON H prosthesis sutured in the thoracic aorta defect, whereas two piglets received a 6-cm-long segment of DALLON prosthesis. The evaluation of surgical qualities of both kinds of grafts was performed intraoperatively. The main emphasis was put on the conditions in which the grafts became tight and the way they were handled during the aortal anastomosis. After 3 and 6 months the animals were autopsied. A macroscopic analysis of the incurred preparations was performed. Roent-genograms of the thoracic aorta sections replaced by the grafts were made in order to establish the shape of their lumen and present calcium salt deposits in their region. Light microscopic tests were performed by dying the preparations with hematoxiline and eosine to differentiate tissues and basic morphotic elements; using the van Giesen method, in order to reveal collagenous fibres; using the Weigert method to reveal elastic fibres, and using the Koess method to reveal calcium salt deposits. An ultrastructural evaluation of the internal surface of the grafted vascular sections was performed by a scanning electron microscope. In view of the experimental tests performed it has been established that DALLON H prosthesis used in vascular surgical procedures is not difficult and the prosthesis can be handled in the same way as some other knitted vascular prostheses. DALLON H does not need preclotting and when the blood flow has been restored through the grafted section the prosthesis immediately becomes completely tight. In view of the tests performed no differences in the healing-in process between the modified DALLON H and DALLON prostheses were observed.

In vitro studies of the influence polyester materials with a different degree of surface wettability have on blood haematological parameters and coagulation and fibrinolysis system parameters.

The paper presents the studies of the influence polyester knitings with a different degree of surface wettability have on the coagulation system, fibrinolytic system and blood haematological parameters in in vitro studies. The studies of Human whole blood were performed for 5, 15, 30, 60, 90, 180 and 240 min. In view of the obtained results in has been reported that a hydrophobic surface knitting does not cause important quantitative changes in any of the selected parametes of the coagulation system and fibrinolysis system. A hydrophilic surface polyester knit causes important lengthening of aPTT value and reduced factor XII, IX and VIII activity. A hydrophilic surface polyester knitting causes a bigger decrease in leukocytes and blood platelets and a bigger increase in beta thromboglobulin in relation to the hydrophobic surface knitting. Neither hydrophobic surface knit nor hydrophilic surface knitting cause changes in the erythrocyte system.

Intraoperative studies and studies on selected parameters of coagulation and fibrinolysis following implantation of DALLON H prostheses with greater surface wettability.

TRICOMED S.A. (Poland) has modified its own knitted polyester vascular prosthesis by change in its physical and chemical characteristics and using hydrophilia. The work has aimed at evaluation of intraoperative tightness and evaluation of change in the number of selected parameters of coagulation and fibrinolysis following implantation of a hydrophilic vascular graft into the thoracic aorta defect in piglets. In view of the experimental tests performed it has been noticed that use of DALLON H prosthesis is easy and the handling of the graft is the same as that of other knitted vascular grafts. DALLON H prosthesis does not need preclotting and it reaches immediate tightness after the blood flow has been restored. In view of the results of the blood studies after implantation coagulation activation in endogenous and exogenous system (aPTT and PT), and increase in activity of factor XII and VII. Concentration of fibrinogen was at a higher level. Thrombin III activation remained at the same level after a primary increase, but protein C activation was decreased. Plasminogen activation was higher which means that the fibrinolytic system was activated. Changes in the level of evaluated indicators were observed until day 14 after implantation of the prosthesis. On day 21st the values of the selected parameters were equal with the values prior to implantation.