Пріоритетні Напрями Хірургічного Лікування Поранених З Ушкодженням Периферичних Нервів Верхньої Кінцівки При Поліструктурних Травмах

Страфун, С.С.; Borzykh, N.O.; Haiko, O.G.; Borzykh, O.V.; Gayovich, Vasyl; Tsymbaliuk, Ya.V.

doi:10.22141/1608-1706.3.19.2018.136410

Cited by 3 publications

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“…During the last decade the incidence of severe peripheral nerves' and plexus injuries such as complete nerve trunk transection or nerve injury remains high in continuity and tends to grow [1]. Such nerve injuries are often observed not only among civilians but also among war casualties [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Early Experimental Results of Nerve Gap Bridging with Silicon Microwires

Likhodiievskyi¹

2019

Innov Biosyst Bioeng

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Background. The incidence of severe peripheral nerves and plexus injuries tends to grow. Autoneurografting is considered as a golden standard method of nerve gap bridging, but existing shortcomings such as additional surgery measures, denervation of other segments of the body, discordance of the neurovascular structure of the damaged nerve and autograft stipulate the development of new material and treatment methods. Objective. The current study is aimed at estimation of the impact of silicon wires on early morphological changes of the parts of the damaged peripheral nerve after nerve injury and grafting with the use of silicon wires. Methods. Study was performed on Wistar rats that were divided into groups: I (n = 10) was sham-operated, II (n = 10) with 10 mm sciatic nerve gap bridged with autoneurograft, III (n = 10) with nerve gap bridged with freeze-thaw decellularized allogenic aorta filled with 4% carboxymethylcellulose hydrogel, IV (n = 10) with nerve gap bridged with same conduit as III along with longitudinal oriented silicon wires (p-type, Boron-ligated). Parts of the sciatic nerve were harvested for histologic study: 1 week postoperatively the proximal nerve stump, proximal stump-to-graft site and graft site itself were analyzed. 3 weeks after surgery the proximal nerve-to-graft junction and graft site were analyzed. Longitudinal frozen sections were stained with nitric silver via modified Bielschowsky method. The number of nerve fibers was statistically measured and compared. Results. It is stated that 1 week after surgery rats from groups II, III, and IV demonstrated signs of nerve fibers irritation in proximal nerve stump. Proximal nerve-to-graft junction contained thin nerve fibers and moderate amount of cells in group II, but a substantial amount of cells, blood vessels and newly-formed nerve fibers in groups III and IV. Graft site contained degenerated nerve fibers in group II, homogeneous semi-transparent masses in group III and same masses with silicon wires in group IV. 3 weeks after surgery rats from group II demonstrated heterogeneous chaotic distribution of nerve fibers at the proximal nerve-tojunction site and heterogeneous distribution of nerve fibers at the graft site. Group III had proximal neuroma site that was composed of substantial amount of chaotically oriented nerve fibers. Graft site contained thin heterogeneously distributed nerve fibers inside the conduit, which were situated alongside the conduit wall or close to vessels. Group IV had proximal neuroma site that was composed of newly-formed nerve fibers that were situated in certain order and mixed with cells and vessels. At the conduit site, thin nerve fibers grow inside conduit lumen, mixed with vessels, and shift towards the silicon wires. Conclusions. It can be concluded about the possible tendency of the pro-regenerative effect of silicon wires, used as a component of the nerve graft, as evidenced by more homogeneous and complete graft site neurotization along with the possible appearance of the nerve interface "nerve fibe...

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Section: Introductionmentioning

confidence: 99%

Early Experimental Results of Nerve Gap Bridging with Silicon Microwires

Likhodiievskyi¹

2019

Innov Biosyst Bioeng

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Surgical Treatment of Peripheral Nerves Combat Wounds of the Extremities

et al. 2021

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The aim: Improving the effectiveness of patients' treatment with combat injuries of the peripheral nervous system, which consists in the application and development of new methods of reconstructive interventions, optimizing a set of therapeutic and diagnostic measures for the most effective management of this category of patients with peripheral nerve injury. Materials and methods: The research is based on the results of surgical treatment of 138 patients with combat injuries of peripheral nerves for the period from 2014 to 2020. The mean age was 33.5 ± 2.1 years. Patients were treated for 1 to 11 months after injury (median – 8 months). Damage to the sciatic nerve was observed in 26.1%, ulnar – in 20.3%, median – in 18.8%, radial – in 15.9%, tibial – in 10.9%, common peroneal nerve – in 8% of cases. Results: It was shown that in all patients was significantly improved the recovery of all nerves. In the period from 9 to 12 months, the degree of recovery of motor function to M0-M2 was observed in 40.6%, to M3 – in 35.5%, to M4 – in 16.7%, to M5 – in 7,2%. The degree of recovery of sensitivity to S0-S2 was observed in 36.2%, to S3 – in 42.8%, to S4 – in 17.4%, to S5 – in 3.6%. Regression of pain syndrome after surgery was observed in 81.2% of patients. Conclusions: The results of surgical treatment of peripheral nerves gunshot injury are generally worse than other types of nerve injuries. The best results of surgical treatment of combat trauma of peripheral nerves are obtained in patients with sciatic nerve damage.

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Features of the Occurrence and Development of Infectious Complications in Patients with Combat Injuries of the Musculoskeletal System (according to the Own Experience)

Hrytsai

Poliachenko

Tsokalo

et al. 2023

HOTP

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Background. One of the characteristics of a combat injury is the penetration of pathogenic microorganisms, pieces of dirty skin, clothes, dust, etc. into the depth of the wound. The combination of significant defects of bones and soft tissues, vessels and nerves of the affected segment of the limb (musculoskeletal system) causes a high percentage of unsatisfactory treatment results, as well as the development of infectious complications. Objective: to evaluate the nature of combat wounds in patients who had infectious complications in the musculoskeletal system during the war in Ukraine since 2014; to determine the features of the occurrence and development of such infectious complications. Materials and Methods. An analysis of case reports of patients with combat wounds with infectious complications (osteomyelitis, septic arthritis, surgical site infection (SSI), purulent- necrotic infection of soft tissues and wounds) who were treated at the Department of Bone- Purulent Surgery of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” for the period from 2014 to mid-2022 was carried out. Results and Conclusions. Infectious complications in combat wounds mostly arise primarily as a result of the wound itself, taking into account the severity, extent of damage to structures and tissues, the type of weapon used to inflict the injury, and a wide spectrum of microorganisms, among which Staphylococcus aureus plays a leading role. In the control group, infectious complications occurred more often than SSI with further progression.

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Пріоритетні Напрями Хірургічного Лікування Поранених З Ушкодженням Периферичних Нервів Верхньої Кінцівки При Поліструктурних Травмах

Cited by 3 publications

References 0 publications

Early Experimental Results of Nerve Gap Bridging with Silicon Microwires

Early Experimental Results of Nerve Gap Bridging with Silicon Microwires

Surgical Treatment of Peripheral Nerves Combat Wounds of the Extremities

Features of the Occurrence and Development of Infectious Complications in Patients with Combat Injuries of the Musculoskeletal System (according to the Own Experience)

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