Úvod: Abdominálna hysterektómia je jednou z najčastejšie vykonávaných operácii v gynekológii. Šicí materiál polyglaktín 910 impregnovaný s antibakteriálnym činidlom triklosan môže znížiť frekvenciu infekčných pooperačných komplikácií a následne skrátiť dobu hospitalizácie. Materiál a metódy: Štúdie sa zúčastnilo 450 pacientok, ktoré podstúpili abdominálnu hysterektómiu v období od augusta 2008 do augusta 2018. Sledovali sa nasledovné premenné: C-reaktívny proteín, pooperačné užívanie antibiotík, maximálna telesná teplota, trvanie a náklady hospitalizácie. Výsledky: V skupine žien, u ktorých sa použil steh s triklosanom, bol zápalový marker CRP signifikatne nižší (p < 0,002) ako v skupine, kde sa použil konvenčný šicí materiál bez triclosanu. Rovnako tak bola v skupine žien s použitím šicieho materiálu s triklosanom významne nižšia maximálna telesná teplota počas celého obdobia hospitalizácie (p = 0,004), aplikácia pooperačných antibiotík bola signifikantne nižšia (p < 0,001), dĺžka pobytu v nemocnici bola signifikantne kratšia (p < 0,001) a náklady, počítané na lôžko dni, boli tiež signifikantne nižšie (p < 0,001). Záver: Usudzujeme, že aplikácia šicieho materiálu s triklosanom môže mať preventívne účinky na infekčné komplikácie. Najmä vaginálna rana je oblasť s najvyššou kolonizáciou patogénov. Preto najmä na sutúru pošvovej rany odporúčame aplikovať šicí material polyglaktín 910 potiahnutý triklosanom, aby sa eliminovalo riziko lokálnej infekcie.
Background: Abdominal hysterectomy is one of the most frequently performed surgical procedures in gynecology. The new coated polyglactin 910 sutures with the antibacterial agent triclosan may help to reduce the frequency of infectious postoperative complications and consequently shorten the duration of hospital stay. Materials and methods: The study was carried out with 450 patients who underwent abdominal hysterectomy between August 2008 and August 2018. The following factors were taken into account: C-reactive protein, the application of post-operative antibiotics, the maximum body temperature, the duration and the cost of hospitalization. Results: In those cases where triclosan-coated suture was used, the phlogistic C-reactive marker was significantly lower (p < 0.002) than in the group where conventional suture without triclosan was used, the maximum body temperature during the whole period of hospitalization was also significantly lower (p = 0.004), the application of post-operative antibiotics was significantly lower (p < 0.001), the length of hospital stay was significantly shorter (p < 0.001), and the costs, calculated in treatment days, were also significantly lower (p < 0.001). Conclusions: It can be concluded that the application of the sutural material with triclosan offers real benefits in the prevention of infectious complications. Particularly, the vaginal wound is the region with the highest colonization of pathogens. Therefore, for the suture of the vaginal wound in particular, we especially recommend applying triclosan-coated polyglactin 910 suture in order to eliminate the risk of local infection resulting directly from the use of the sutural material.
- MeSH
- Anti-Infective Agents, Local * MeSH
- Hysterectomy * MeSH
- Surgical Wound Infection * prevention & control MeSH
- Humans MeSH
- Polyglactin 910 pharmacology MeSH
- Postoperative Complications MeSH
- Sutures MeSH
- Triclosan pharmacology MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Comparative Study MeSH
The current limitations of calcium phosphate cements (CPCs) used in the field of bone regeneration consist of their brittleness, low injectability, disintegration in body fluids and low biodegradability. Moreover, no method is currently available to measure the setting time of CPCs in correlation with the evolution of the setting reaction. The study proposes that it is possible to improve and tune the properties of CPCs via the addition of a thermosensitive, biodegradable, thixotropic copolymer based on poly(lactic acid), poly(glycolic acid) and poly(ethylene glycol) (PLGA⁻PEG⁻PLGA) which undergoes gelation under physiological conditions. The setting times of alpha-tricalcium phosphate (α-TCP) mixed with aqueous solutions of PLGA⁻PEG⁻PLGA determined by means of time-sweep curves revealed a lag phase during the dissolution of the α-TCP particles. The magnitude of the storage modulus at lag phase depends on the liquid to powder ratio, the copolymer concentration and temperature. A sharp increase in the storage modulus was observed at the time of the precipitation of calcium deficient hydroxyapatite (CDHA) crystals, representing the loss of paste workability. The PLGA⁻PEG⁻PLGA copolymer demonstrates the desired pseudoplastic rheological behaviour with a small decrease in shear stress and the rapid recovery of the viscous state once the shear is removed, thus preventing CPC phase separation and providing good cohesion. Preliminary cytocompatibility tests performed on human mesenchymal stem cells proved the suitability of the novel copolymer/α-TCP for the purposes of mini-invasive surgery.
- MeSH
- Biocompatible Materials chemistry MeSH
- Calcium Phosphates chemistry MeSH
- Hydrogen-Ion Concentration MeSH
- Bone Cements chemistry MeSH
- Cells, Cultured MeSH
- Humans MeSH
- Mechanical Phenomena MeSH
- Molecular Structure MeSH
- Polyesters chemistry MeSH
- Polyethylene Glycols chemical synthesis chemistry MeSH
- Polyglactin 910 chemical synthesis chemistry MeSH
- Polymerization MeSH
- Rheology MeSH
- Materials Testing MeSH
- Cell Survival MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Nanofibre-based mucoadhesive films were invented for oromucosal administration of nanocarriers used for delivery of drugs and vaccines. The mucoadhesive film consists of an electrospun nanofibrous reservoir layer, a mucoadhesive film layer and a protective backing layer. The mucoadhesive layer is responsible for tight adhesion of the whole system to the oral mucosa after application. The electrospun nanofibrous reservoir layer is intended to act as a reservoir for polymeric and lipid-based nanoparticles, liposomes, virosomes, virus-like particles, dendrimers and the like, plus macromolecular drugs, antigens and/or allergens. The extremely large surface area of nanofibrous reservoir layers allows high levels of nanoparticle loading. Nanoparticles can either be reversibly adsorbed to the surface of nanofibres or they can be deposited in the pores between the nanofibres. After mucosal application, nanofibrous reservoir layers are intended to promote prolonged release of nanoparticles into the submucosal tissue. Reversible adsorption of model nanoparticles as well as sufficient mucoadhesive properties were demonstrated. This novel system appears appropriate for the use in oral mucosa, especially for sublingual and buccal tissues. To prove this concept, trans-/intramucosal and lymph-node delivery of PLGA-PEG nanoparticles was demonstrated in a porcine model. This system can mainly be used for sublingual immunization and the development of "printed vaccine technology".
- MeSH
- Adhesives chemistry MeSH
- Administration, Buccal MeSH
- Administration, Sublingual MeSH
- Pharmaceutical Preparations administration & dosage MeSH
- Drug Delivery Systems methods MeSH
- Liposomes chemistry MeSH
- Lymph Nodes metabolism MeSH
- Mice MeSH
- Nanoparticles chemistry MeSH
- Nanofibers chemistry MeSH
- Polyethylene Glycols chemistry MeSH
- Polyglactin 910 chemistry MeSH
- Swine MeSH
- Mouth Mucosa metabolism MeSH
- Vaccination methods MeSH
- Vaccines administration & dosage MeSH
- Animals MeSH
- Check Tag
- Mice MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Episiotomy methods instrumentation MeSH
- Humans MeSH
- Polyglactin 910 MeSH
- Birth Injuries surgery MeSH
- Check Tag
- Humans MeSH
- Female MeSH
