2014年5月29日星期四

Aerospace titanium castings easily fixed but also limits

Titanium plate placed in the skull defect repair application
A skull defect lines are required to be greater than 3cm2 skull defect repair. Defects can be repaired using titanium casting a variety of materials, including autologous bone, allograft bone, bone cement, hydroxyapatite, titanium plates, etc.
. Ideal cranioplasty material should be: good histocompatibility, non-toxic, non-carcinogenic, is a poor conductor of electricity and heat, through X-rays, for CT, MRI, EEG and other tests is small, rugged
Durable, easy shaping and so on. Because high plexiglass brittle, broken again under external force may gradually be abandoned; bone cement due to expensive, making trouble, easily fixed, but also limits
Its application.
2 titanium plate as an ideal repair material has the following advantages: ① and tissue compatibility, non-toxic, non-aging, non-corrosive, light tissue reaction, which bore a large and dense, titanium sponge plant is conducive to liquid
Drainage and granulation tissue throughout the body of the growth of fixed titanium; ② titanium plate strength to meet the requirements, resisting ability and strong; ③ appropriate titanium plate thickness, and the skull is similar, sophisticated technology, easy-to-shaping;
④ surgery operation is safe, simple, directly on the edge of skull defects, with special tools, can be directly from titanium titanium screw hole drilled into the skull and a constant; ⑤ preoperative pasteurized side
It easy; ⑥ non-magnetic, for X-ray, CT, MRI had no significant effect.
3 However, in clinical applications, titanium plates exposed is a common complication, although restored, is still likely exposed again. To prevent the exposed titanium and other complications, such as infection
Head flap blood supply, the dura and brain tissue damage, we in clinical practice, to pay attention to the following matters, effectively avoid complications.
(1) Select the curved incision, flap blood supply Note: in the repair, the prosthesis is exposed causes include local tension is too high, poor blood supply to the flap. If you choose linear incision, defect disposition into
After the titanium plate, wound itself, there will be tension, if the tension is reduced to a minimum, the opportunity to put into the body exposed greatly increased. Select curved incision can reduce tension and promote healing
Together. Also note the direction of the flap blood supply. Arterial supply to the top of the scalp are distributed from the periphery, so the design must take into account the flap position of the pedicle, particularly for
Away from the original incision design, but also to pay attention to this issue because of the scalp defect is often scar tissue, the blood supply is poor, do not separate too shallow peel flap. If the lack of intraoperative findings
Loss of blood supply to the scalp area is bad, and must not barely stitched, so the tension is too large, there will be exposed implant, and then need to transfer the local head flap to cover the wound, conducive to wound healing .
(2) isolated from normal to abnormal tissue organization: If you select the original scar incision, the incision may be due to the deep surface is bulging brain tissue caused the damage, but local scar will affect injury
Mouth healing. Choose Titanium Welded Tubes away from the incision, the first can ensure good healing, but separated from the normal subgaleal lower to defect, but also to avoid damage to the dura and brain
Organization, a thorough understanding of the situation defects.
(3) application of tension-suture technique: To reduce the chance of implant exposed suture technique should be noted. Scalp whole layer of neurosurgery using suture method, you can enter
Line improvements, using layered plastic surgery suture, absorbable suture respectively subgaleal layer silk suture skin and skin, to reduce the tension to a minimum.
(4) the timing of surgery reasonable options: repair the skull is also the opportunity to choose, such as 3 to 6 months after the scalp scar has softened, traumatic brain injury patient's condition has stabilized, the general condition
Has improved, hernia disappear, titanium sheet metal intracranial pressure decreased, the site of a partial craniectomy scalp retraction, the wound is completely healed without infection, you can choose surgery. For children who histiocytes new generation of Chen
Xiewang Sheng tissue healing, cranial growth, restore the integrity of the cranial cavity as soon as possible, is conducive to the development of the cranial cavity, so the child can properly repair the skull of time in advance.

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