RAND SF-36 scores seem to provide a useful tool to evaluate the health-related quality of life after pelvic pouch operation for ulcerative colitis. Frequent bowel movements, impaired anal continence, and pouchitis are common in long-term follow-up after ileal pouch operation. The scores were, however, comparable to those in the normal population in terms of adaptation to daily life with a pelvic pouch.
The practice of using implants is growing day by day, and more foreign materials are being inserted for various indications. The field of implantology thus deserves intensive research and careful evaluation of results. Solutions to overcome current problems and risks are necessary. It has taken a long time to arrive at where we are now. Bioabsorbable devices were explored in the 1960s for surgical bone fixation. Failures were followed by changes in ways of thinking and innovations. Improvements in the strength properties and biocompatibility were achieved. Bioabsorbable polymeric materials such as high-molecular-weight polymers were used and also reinforced with other material or, more recently, by self-reinforcement to produce small yet strong devices. New generations of implants include those that contain bioactive substances such as antibiotics and growth factors. Developments in bioabsorbable materials continue to accommodate the new way of thinking brought about by the emergence of the field of tissue engineering. Surgeons, conversely, are also inventing new surgical techniques and methods to exploit the plastic and bioabsorbability properties of these materials for the better future of our patients. Such a multidisciplinary approach that involves surgeons and materials scientists should help to find solutions to the current limitations of these devices.
Minor morbidity is common after RPC. Pouchitis occurred in half of our patients during long-term follow-up. There may be a risk of anemia with chronic pouchitis and bleeding from the pelvic pouch mucosa.
The aim of this study was to assess tissue reactions to bioabsorbable self-reinforced polylactide/polyglycolide (SR-PLGA) 80/20 miniscrews in rabbit cranial bone. One PLGA screw was implanted on one side and one titanium screw on the other side of the sagittal suture (n = 21). Three animals were sacrificed after 2, 4, 8, 16, 24, 54, and 72 weeks. In histological examination the numbers of macrophages, giant cells, active osteoblasts, and fibrous tissue layers were assessed and degradation of the bioabsorbable screws was evaluated. After 2 weeks, macrophages were seen near the heads of both screws. After 4 and 8 weeks, the bioabsorbable screws were surrounded by fibrous tissue. Osteoblastic activity and groups of several giant cells were seen. After 24 weeks, a significant change in the morphology of the PLGA screws had occurred. Osteoblastic activity and the amount of giant cells had decreased. After 1 year, some PLGA biomaterial was still present. PLGA screws had been replaced by adipose tissue, fibrous tissue, and "foamy macrophages" that had PLGA particles inside them. After 1(1/2) years, the amount of biomaterial remaining had decreased remarkably. The particles of biomaterial were inside foamy macrophages. SR-PLGA 80/20 screws are biocompatible and have no clinically manifested complications when used in the cranial bone of rabbits. No contraindications as regards their clinical use in craniofacial surgery was found when these screws were studied in the cranial bones of rabbits.
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