Application of Biological Glue in Orthopedics and Traumatology

The purpose of the study was to investigate the method of osteosynthesis using glues. Materials and methods. The simplest and most effective method in the treatment of traumatological patients is a plaster fixing bandage of different variations. This is a conservative type of treatment. Also, a very common method in the treatment of orthopedic and traumatological patients is the surgical method. Modern high-tech methods of osteosynthesis require a thorough preoperative examination of the patient, conducting a 3D tomographic examination for intra-articular fractures, clear planning of the course of surgical intervention, electro optical probing techniques during the operation, the availability of tool kits for installing retainers, the ability to choose a retainer intraoperative in the size range. An orthopedic-traumatologist and the entire operating team need appropriate training. All operational fixation methods must provide adequate stability to maintain axis length and rotation. Results and discussion. In the world practice, biological glues are used in such areas as abdominal surgery, neuro- and cardiac surgery, plastic and pediatric surgery, orthopedics and traumatology. Cyanocrylate glues have undergone extensive experimental clinical testing. Positive characteristics of cyanoacrylate glues are the ability to glue living tissues in a humid environment, polymerization rate, autosterility, bactericidal, absence of histotoxicity, hemostatic effect. Another glue in the review is sulfacrylate. It can be used in patients of any age, starting from newborns, regardless of the pathogenesis of the disease. Venaseal glue, used by many authors to treat fistulas of the gastrointestinal tract. Widely used fibrin glues, such as Evicel, are used to achieve hemostasis and sealing in surgery, for example, in vascular operations, kidney resection and neurosurgical interventions, in the surgical treatment of distal hypospadias in children. BioGlue glue is designed to seal surgical sutures, thereby preventing fluids (exudate, lymph, urine, gastric juice) and / or air from leaking through them. It is also used in liver surgery. At the moment, the use of bone cement is the most common auxiliary method for surgical interventions. But its side effects are very clear. Bone cement can cause the patient to die on the operating table or, in the postoperative period, in intensive care. This is due to an immediate or rapid allergic reaction. This situation is dangerous for humans. Biological glues are not so toxic and do not cause such allergic reactions Conclusion. The search for new materials and techniques for consolidating bone fragments is one of the most important problems of modern medical science, namely orthopedics and traumatology. Substances that are included in the biological glue must be bioinert, contain elements of strength (for holding fragments), looseness of the structure (for germination of capillaries between fragments), natural antibiotic (for antibiotic prevention), activators of hematopoiesis processes (for the fastest callus), organic and inorganic substances (for the building material of bone tissue). Therefore, the desire to improve treatment and improve its results, in particular in orthopedics and traumatology, is the key to the development of modern medicine

Virulent Acne Biofilms Offer Insight into Novel Therapeutic Options

Acne vulgaris is a disease of the pilosebaceous unit that may manifest as either noninflammatory or inflammatory skin lesions. The microcomedone theory suggests that the first step in the pathogenesis of acne vulgaris is the noninflammatory comedone. The comedone is a collection of keratin and sebum that is trapped within the pilosebaceous unit due to hyperproliferation of keratinocytes in the follicular lining. The biofilm produced by P. acnes bacteria promotes the formation of a comedone by acting as a biological glue that prevents expulsion of the hyperkeratotic plug. In addition to its adhesive properties, the biofilm has virulence factors contributing to the pathogenicity of P. acnes in acne vulgaris. With further investigation and a better understanding of the P. acnes biofilm, new therapeutic options for acne vulgaris can be made available. By targeting the P. acnes biofilm, treatment can be made more effective and precise, without the concern of side effects seen in currently available acne medications.

Ossified pseudomeningocele after the removal of an intradural neurinoma in the lumbar spine. A case report and literature review

The study objective is to describe a case of ossified pseudomeningocele after spinal surgery and to develop an optimal treatment strategy for this disorder.Materials and methods. We report a case of ossified pseudomeningocele developed after the removal of an intradural neurinoma in the lumbar spine in a female patient treated in the Clinic for Nervous Diseases, University Clinical Hospital No. 3 of the I.M. Sechenov First Moscow State Medical University in 2017. We also reviewed research literature describing this pathological condition.Results. Upon admission, the patient was diagnosed with paresis of the left foot occurring in ankle joint dorsiflexion (score 4), absence of the Achilles reflex on the left side, and hypoesthesia of two first toes of the left foot. Magnetic resonance imaging revealed a postoperative cyst of irregular shape located in soft tissues at the level of L vertebral body and compressing the dural sac. The patients underwent surgery that included separation of the pseudomeningocele cavity from the dural sac and placement of an external lumbar drainage. In the postoperative period, we observed a complete regression of neurological symptoms.Conclusion. Since ossified pseudomeningocele in the lumbar spine is extremely rare, an optimal treatment strategy has not been developed so far. We believe that maximum possible excision of the cyst wall and anastomotic sealing with a muscular or fat flap with biological glue followed by flap fixation from the extradural space is a simple and robust method of decompression and separation of the anastomosis. To eliminate the cavity in soft tissue of the paravertebral space, we recommend reconstruction of epidural fat with additional sealing using biological glue. To prevent anastomosis recurrence, we recommend placing an external lumbar drainage.