The Opportunity of Using Platelet Concentrates as an Adjuvant Tool for In-hospital Management of Bone Defects

Author(s):  
Petru Ciobanu ◽  
Norin Forna ◽  
Andrian Panuta ◽  
Alexandru Covaciu ◽  
Victor Niculescu ◽  
...  
Author(s):  
S. Shevchenko

The results of the dynamics of the morphological parameters of the blood of a rabbit with model defects of the opening of the spongy and compact bone tissue at diff erent periods of reparative osteogenesis are presented. Formed 4 groups of rabbits. Bone lesions in the fi rst experimental group were fi lled with injectable platelet-rich fi brin, in the second - platelet-rich fi brin, in the third - a combination of platelet-rich fi brin, and hydroxyapatite with β-tricalcium phosphate.In the control group, the defects remained healed under a blood clot. All animals were in the same conditions of feeding and keeping, had unlimited access to water. During the study, rabbits were clinically observed. Blood was taken for morphological examination before surgery and on the 3rd, 7th, 14th, 21st, 42nd day. Animals were taken from the experiment on the 14th, 21st and 42nd days, an X-ray examination was carried out, bone tissue samples were taken. It was established that trauma of bone tissue leads to a number of reactions of the body aimed at restoring the damaged area. Against the background of the general picture of the obtained morphological results, the level of platelets signifi cantly changes compared to the physiological norm, while the number of red blood cells and white blood cells does not go beyond it. There is a slight increase in hemoglobin levels, especially in the experimental groups on the twenty-fi rst and forty-second day. Signifi cant changes in the number of red blood cells, white blood cells, platelets and hemoglobin concentration in the experimental groups were noted compared with the control group at diff erent periods of reparative osteogenesis.The use of various types of platelet concentrates aff ects the overall reaction of the body. On radiographs of the radial bones (compact bone tissue) on the twenty-fi rst day in the second and third experimental groups, where fi brin enriched with platelets and its combination with hydroxyapatite materials with β-tricalcium phosphate were used to replace bone defects, the infl ammatory reaction was manifested to a lesser extent. There was no signifi cant formation of bone callus compared with the fi rst, in which model defects were fi lled with injectable platelet-rich fi brin and the control group. Each of the types of platelet concentrates and their combination with hydroxyapatite ceramics have a diff erent eff ect on the restoration of bone defects and is accompanied by the appearance of a number of reactions, both local and general. According to the degree of intensity of this process, they can be placed in the following sequence: i-PRF ˂ PRF ˂ PRF+GT. Macromorphologically and radiologically signifi cant diff erences were not detected for diff erent types of bone tissue due to the use of each of the substances that concentrates platelets. The combination of hydroxyapatite granules with β-tricalcium phosphate and platelet-rich fi brin proved to be the best option for repairing the damaged area. Its use provides a signifi cantly smaller manifestation of the local infl ammatory reaction and causes the formation of optimal bone marrow. Key words: PRF, i-PRF, granules, centrifuges, growth factors, bone marrow.


2017 ◽  
Vol 74 (1) ◽  
pp. 796-804
Author(s):  
Werner F. Kübler

Zusammenfassung. Die neue Spitalfinanzierung mit SwissDRG-Fallpauschalen hat seit 2012 zu Preistransparenz und stabilen oder sinkenden Spitalpreisen bei steigendem Marktvolumen geführt. Die meisten Spitäler sind in dieser Zeit kosteneffizienter geworden. Verschlechterungen der Qualität und Sparen auf Kosten des Personals sind bislang in der Schweiz nicht nachgewiesen. Die Anstrengungen zur weiteren Effizienzsteigerung beinhalten Verbesserungsprogramme, die medizinische Qualitätsverbesserung, optimierte Patientenprozesse und Kosteneffizienz gleichzeitig adressieren. Eine bekannte Methodik dafür liefert Lean Hospital Management. Die Optimierung der hochkomplexen Spitalabläufe braucht harte Arbeit, Ausdauer und das Engagement der Führung und aller Berufsgruppen. Die Spitäler arbeiten sorgfältig und kontinuierlich. Erfolge stellen sich langsam aber nachhaltig ein. Zukünftige Fortschritte werden entscheidend durch die Digitalisierung der Medizin und der Gesundheitsversorgung ermöglicht. Prozesse und bessere Messsysteme für die medizinische Qualität und die Ergebnisse werden durch Digitalisierung und Vernetzung gestaltet. Um die Potenziale freizusetzen, müssen bestehende finanzielle und tarifliche Fehlanreize und Grenzen zwischen den Versorgungsstrukturen abgebaut werden. Innovative Entgeltsysteme müssen entwickelt werden, um vermehrt den Nutzen der Behandlungen abzugelten und die Akteure darauf auszurichten. Effizienz im Spital wird sich in den nächsten Jahren von einem ressourcenbezogenen Produktivitätsansatz beim einzelnen Leistungserbringer zu einem balancierten Ansatz im Sinne von Qualität und optimalen Behandlungsabläufen und weiter zu einer umfassenden Betrachtung von Patientennutzen und medizinischem Outcome über die ganze Behandlungskette wandeln.


2001 ◽  
Vol 28 (1) ◽  
pp. 73-80 ◽  
Author(s):  
M. G. Araujo ◽  
D. Carmagnola ◽  
T. Berglundh ◽  
B. Thilander ◽  
J. Lindhe

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
Martin Blaha ◽  
Michal Tichy ◽  
Juraj Schwab ◽  
Lubomír Pekař ◽  
Jiří Kozák

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