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The vascularized allotransplant– successful alternative for massive bone defects

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dc.contributor.author Pavlovschi, Elena
dc.contributor.author Stoian, Alina
dc.contributor.author Mihaluta, Viorica
dc.date.accessioned 2020-07-17T06:32:19Z
dc.date.available 2020-07-17T06:32:19Z
dc.date.issued 2018
dc.identifier.citation PAVLOVSCHI, Elena, STOIAN, Alina, MIHALUTA, Viorica. The vascularized allotransplant– successful alternative for massive bone defects. In: MedEspera: the 7th Internat. Medical Congress for Students and Young Doctors: abstract book. Chișinău: S. n., 2018, p. 143-144. en_US
dc.identifier.uri https://medespera.asr.md/wp-content/uploads/Abastract-Book-2018.pdf
dc.identifier.uri http://repository.usmf.md/handle/20.500.12710/11343
dc.description Department of Traumatology and Orthopedics, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova en_US
dc.description.abstract Introduction. The massive bone defects after trauma, in congenital anomaly, tumors, infections or nonunions is a real dilemma for reconstructive surgery of the locomotor system. Contemporary methods that are usually used for reconstruction of the bone structure are: bone transplant, cryopreserved allografts, autograft or prosthesis, having high levels of morbidity and complication rates. Their common features are bad blood circulation and unviability, resulting in mechanical instability and poor bone consolidation (periprosthetic fractures, stress fractures, pseudoarthrosis, sepsis). Aim of the study. To determine what are the different methods used in reconstruction of massive bone defects. Materials and methods. Scientific papers and research results regarding bone defects reconstruction methods were reviewed. Review. A vascularized bone graft, reclosed microsurgicaly in the circuit, has a good potential for regeneration, plasticity, and a post-graft mechanical stiffness. The vascular bone autograft, with all biological and mechanical characteristics is considered the "gold standard" in the treatment of small bone defects. However, it becomes insufficient in size, shape and cellular repair capacities in the case of massive bone defects due to the increased circulatory needs of the injured segment. Maintaining the osteoplastic properties of the vascularized autograft and combining them with the orthotopic characteristics of an allogene bone or bone segment would be a successful alternative for the reconstructive surgery of the locomotor. The dilemma imposed by vascularized composite allotransplantation (VCA), is immunosuppression (IS) and immunomodulation for life, which is not justified in case of vital organs (heart, liver, kidneys) transplants, because of adverse effects risk (systemic complications, sepsis, neoplasms). Without an IS, the immune cascade will cause vascular endothelial cell lysis, compromise microcirculation with necrosis of the graft. The last studies, describe the surgical neoangiogenesis typical of the host in VCA with a short-term IS - 14 days, as an effective one, with results that allow consolidation and mechanical stability. Studies are performed preclinically on rats, rabbits and pigs. Other studies present decelularization methods of the vassel while preserving vascular stiffness. Conclusions. A perfect alternative in treatment of the massive bone defects is using a vascular allograft, without associated immunosuppression. en_US
dc.language.iso en en_US
dc.publisher MedEspera en_US
dc.subject massive bone defects en_US
dc.subject reconstruction en_US
dc.subject allograft en_US
dc.title The vascularized allotransplant– successful alternative for massive bone defects en_US
dc.type Article en_US


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  • MedEspera 2018
    The 7th International Medical Congress for Students and Young Doctors, May 3-5, 2018

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