• 제목/요약/키워드: Bioabsorbable

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The Efficacy of Bioabsorbable Mesh as an Internal Splint in Primary Septoplasty

  • Kim, Jee Nam;Choi, Hyun Gon;Kim, Soon Heum;Park, Hyung Jun;Shin, Dong Hyeok;Jo, Dong In;Kim, Cheol Keun;Uhm, Ki Il
    • Archives of Plastic Surgery
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    • 제39권5호
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    • pp.561-564
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    • 2012
  • Nasal bone fractures are often accompanied by septal fractures or deformity. Posttraumatic nasal deformity is usually caused by septal fractures. Submucosal resection and septoplasty are commonly used surgical techniques for the correction of septal deviation. However, septal perforation or saddle nose deformity is a known complication of submucosal resection. Hence, we chose to perform septoplasty, which is a less invasive procedure, as the primary treatment for nasal bone fractures accompanied by septal fractures. During septoplasty, we used a bioabsorbable mesh as an internal splint. We used the endonasal approach and inserted the mesh bilaterally between the mucoperichondrial flap and the septal cartilage. The treatment outcomes were evaluated by computed tomography (CT) and the nasal obstruction symptom evaluation (NOSE) scale. The CT scans demonstrated a significant improvement in the septal deviation postoperatively. The symptomatic improvement rated by the NOSE scale was greater at 1 month and 6 months after surgery compared to the preoperative status. There were no cases of extrusion or infection of the implant. In cases of moderate or severe septal deviation without dislocation from the vomerine groove on the CT scan, our technique should be considered one of the treatments of choice.

슬괵건을 이용한 전방십자인대 재건술시 횡고정 핀과 간섭나사를 이용한 대퇴터널 고정술 -수술 수기- (Cross-Pin and Interference Screw Femoral Fixation in Anterior Cruciate Ligament Reconstruction using Hamstring Tendon -Technical Note-)

  • 인용;박원종;박종범;홍승환
    • 대한관절경학회지
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    • 제6권1호
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    • pp.60-63
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    • 2002
  • 목적 : 네 겹의 슬괵건을 이용한 전방십자인대 재건술시 대퇴터널을 횡고정 핀과 흡수성 간섭나사로 함께 고정하는 수기를 소개하고자 한다. 수술 술기 : 반건양건과 박건을 채취하여 네 겹으로 준비하였다. 경골터널과 대퇴터널을 만드는데 대퇴터널의 깊이는 35 mm로 하였다. Rigidfix system의 가이드를 삽입하고 가이드의 위쪽 관에만 구멍을 내었다. 이식건을 통과시킨후 횡고정 핀 을 고정하였다. 이후 이식건을 경골쪽으로 당기면서 흡수성 간섭 나사로 고정하였다. 결론 : 슬괵건 전방십자인대 재건술시 횡고정 핀과 흡수성 간섭나사를 이용한 대퇴터널 고정은 강한 초기 고정과 이식건의 골통합을 촉진시킬 수 있는 좋은 방법으로 사료되어 소개하였다.

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슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 발생한 골용해 (Osteolysis-Related Bioabsorbable Suture Anchor Fixation in a Medial Collateral Ligament Avulsion Fracture during Total Knee Arthroplasty)

  • 허정욱;박만준;홍성확;박준형
    • 대한정형외과학회지
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    • 제55권6호
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    • pp.545-549
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    • 2020
  • 슬관절 인공관절 치환술 중 드물게 발생하는 내측 측부 인대 견열 골절의 치료는 보조기나 캐스트 등의 보존적 치료, 금속 나사못을 이용한 고정 등의 다양한 치료법이 소개되고 있다. 생흡수성 봉합 나사못은 생체 적합성, 방사선 투과성, 제거를 위한 2차 수술이 불필요하다는 장점 등으로 여러 부위에서 금속 고정물을 대체해 사용되고 있으나 골용해 등의 합병증이 보고되고 있다. 저자들은 슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 심각한 골용해 소견을 경험하여 사용에 신중을 기해야 한다는 판단하에 이에 대한 문헌 고찰과 함께 보고하고자 한다.

흡연이 흡수성 차폐막을 이용한 조직유도재생술의 치유에 미치는 영향 (Influence of Smoking on Short-Term Clinical Results of Periodontal Bone Defects Treated with Regenerative Therapy Using Bioabsorbable Membranes)

  • 강태헌;설양조;이용무;계승범;김원경;정종평;한수부
    • Journal of Periodontal and Implant Science
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    • 제30권2호
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    • pp.305-324
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    • 2000
  • This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes($BioMesh^{(R)}$) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and nonsmokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freeze-dried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and non-smokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.

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Effects of In Vitro Degradation on the Weight Loss and Tensile Properties of PLA/LPCL/HPCL Blend Fibers

  • Yoon Cheol Soo;Ji Dong Sun
    • Fibers and Polymers
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    • 제6권1호
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    • pp.13-18
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    • 2005
  • PLA/LPCL/HPCL blend fibers composed of poly (lactic acid) (PLA), low molecular weight poly ($\varepsilon$-caprolactone) (LPCL), and high molecular weight poly ($\varepsilon$-caprolactone) (HPCL) were prepared by melt blending and spinning for bioab­sorbable filament sutures. The effects of blending time and blend composition on the X-ray diffraction patterns and tensile properties of PLA/LPCL/HPCL blend fibers were characterized by WAXD and UTM. In addition, the effect of in vitro degra­dation on the weight loss and tensile properties of the blend fibers hydrolyzed during immersion in a phosphate buffer solu­tion at pH 7.4 and 37$^{\circ}C$ for 1-8 weeks was investigated. The peak intensities of PLA/LPCL/HPCL blend fibers in X-ray diffraction patterns decreased with an increase of blending time and LPCL contents in the blend fibers. The weight loss of PLA/LPCL/HPCL blend fibers increased with an increase of blending time, LPCL contents, and hydrolysis time while the tensile strength and modulus of the blend fibers decreased. The tensile strength and modulus of the blend fibers were also found to be increased with an increase of HPCL contents in the blend fibers. The optimum conditions to prepare PLA/LPCL/HPCL blend fibers for bioabsorbable sutures are LPCL contents of $5 wt\%, HPCL contents of $35 wt\%, and blending time of 30 min. The strength retention of the PLA/LPCL/HPCL blend fiber prepared under optimum conditions was about $93.5\% even at hydrolysis time of 2 weeks.

관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료 (Arthroscopic Treatment using Bioabsorbable Knotless Anchor for Anterior Instability of Shoulder)

  • 이용재;이동주;임광열;김명구
    • 대한관절경학회지
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    • 제8권2호
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    • pp.103-108
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    • 2004
  • 목적: 견관절의 전방 불안정성이 있는 환자에서 관절경하 생체흡수형 knotless anchor를 이용한 치료 결과를 객관적 및 주관적 평가를 통하여 알아보는데 있다. 대상 및 방법: 2003년 1월부터 2003년 6월까지 본원에서 외상성 견관절 전방 불안정성에 대하여 관절경하 생체흡수형 knotless anchor를 이용하여 Bankart복원술을 시행하고 평균 12개월 추시된 15예를 대상으로 하였다. 환자 구성은 남자가 14명, 여자가 1명이었으며, 평균 연령은 24세 (16세${\sim}$42세)였다. 평균 추시 기간은 14개월(12개월${\sim}$18개월)이었다. 수술시간은 같은 저자에 의해 2002년 1월부터 2002년 10월까지 suture anchor 술기를 이용하여 관절경하 Bankart 복원술을 시행한 20예와 비교하였다. 결과: 수술 후 탈구의 재발이나 아탈구의 발생은 없었으며 Rowe등에 의한 기능적 평가에서 평균 89.4점이었고 환자의 주관적 만족도는 평균 87.5였다. 최종 추시시의 견관절 운동 범위는 각각 굴곡이 평균 171도, 외회전이 평균 54도로 측정되었고 전 예에서 결과에 만족하였으나 3예에서 운동시 불안감각이 남아 있었다. 수술시간은 suture anchor 술기를 이용한 Bankart 복원술에서 1개의 매듭 당 평균 25.5분이 소요되었지만, 생체흡수형 knotless anchor를 이용시 1개의 anchor당 소요 시간은 평균 16.5분으로 의미 있게 감소됨을 알 수 있었다(P<0.05).결론: 견관절 전방 불안정성의 원인인 Bankart병변의 치료에 있어 knotless anchor 술식은 관절낭의 적절한 긴장을 획득하고 수술 시간을 단축하는 장점이 있으며 탈구나 아탈구의 재발없이 견관절 불안정성을 치료할 수 있는 유용한 방법으로 사료된다.

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2급 치근분지부 병소에서의 생분해성 차폐막의 효과 (Treatment of Class II Furcation Involvements in Humans with Bioabsorbable Guided Tissue Regeneration Barriers)

  • 이학철;한승민;설양조;이철우;엄흥식;장범석;정종평;한수부
    • Journal of Periodontal and Implant Science
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    • 제29권3호
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    • pp.539-553
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    • 1999
  • The purpose of this 6-months study was to compare the clinical and radiographic outcomes following guided tissue regeneration treating human mandibular Class II furcation defects with a bioabsorbable BioMesh barrier(test treatment) or a nonabsorbable ePTFE barrier(control treatment). Fourteen defects in 14 patients(mean age 44 years) were treated with BioMesh barriers and ten defects in 10 patients(mean age 48 years) with ePTFE barriers. After initial therapy, a GTR procedure was done. Following flap elevation, root planing, and removal of granulation tissue, each device was adjusted to cover the furcation defect. The flaps were repositioned and sutured to complete coverage of the barriers. A second surgical procedure was performed at control sites after 4 to 6 weeks to remove the nonresorbable barrier. Radiographic and clinical examinations(plaque index, gingival index, tooth mobility, gingival margin position, pocket depth, clinical attachment level) were carried out under standardized conditions immediately before and 6 months after surgery. Furthermore, digital subtraction radiography was carried out. All areas healed uneventfully. Surgical treatment resulted in clinically and statistically equivalent changes when comparisons were made between test and control treatments. Changes in plaque index were 0.7 for test and 0.4 for control treatments; changes in gingival index were 0.9 and 0.5. In both group gingival margin position and pocket depth reduction was 1.0mm and 3.0mm; clinical attachment level gain was 1.9mm. There were no changes in tooth mobility and the bone in radiographic evaluation. No significant(p${\leq }$0.05) difference between the two membranes could be detected with regard to plaque index, gingival index, gingival margin position, pocket depth, and clinical attachment level. In conclusion, a bioabsorbable BioMesh membrane is effective in human mandibular Class II furcation defects and a longer period study is needed to fully evaluate the outcomes.

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백서에서 흡수성막과 탈회동결건조골을 이용한 두개골결손부의 골재생 (GUIDED BONE REGENERATION OF CALVARIAL BONE DEFECTS USING BIOABSORBABLE MEMBRANE AND DEMINERALIZED FREEZE DRIED BONE IN RATS)

  • 김수민;여환호;김수관;임성철
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권4호
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    • pp.290-301
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    • 2002
  • The purpose of this study was to evaluate new bone formation and healing process in rat calvarial bone defects using $BioMesh^{(R)}$. membrane and DFDB. Forty eight rats divided equally into 4 groups of 1 control group and 3 experimental groups. Standardized transosseous circular calvarial defects (8 mm in diameter) were made midparietally. In the control group, the defect was only covered with the soft tissue flap. In the experimental group 1, it was filled with DFDB only, in the experimental group 2, it was covered $BioMesh^{(R)}$. membrane only, and in the experimental group 3, it was filled DFDB and covered with membrane. At the postoperative 1, 2, 4, 8 weeks, rats were sacrificed and histologic and histomorphometric analysis were performed. These results were as follows. In histomorphometric analysis, It showed the greatest amount of new bone formation through experimental in the experimental group 3 (P<0.001). The amount of new bone formation at the central portion of the defect was greater in the experimental group 3 than experimental group 2. $BioMesh^{(R)}$. membrane began to resorb at 1 week and resorbed almost completely at 8 weeks after operation. The collapse of membrane into the defect was observed through the experimental periods in the experimental group 2. In the area of collapsed membrane, new bone formation was restricted. These results suggest that maintenance of some space for new bone to grow is required in the use of $BioMesh^{(R)}$. membrane alone in the defect. It is also thought that use of the membrane may promote new bone growth in DFDB graft.