| 1. |
- Engstrand, Thomas, et al.
(författare)
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A novel biodegradable delivery system for bone morphogenetic protein-2.
- 2008
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Ingår i: Plastic and reconstructive surgery. - 1529-4242. ; 121:6, s. 1920-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The efficacy of recombinant growth factors in vivo is highly dependent on the delivery vehicle. The authors investigated the osteoinductive effects of recombinant human bone morphogenetic proteins (BMP)-2 implanted together with a complex of heparin and chitosan. METHODS: Sixty rats were used. Three different carriers in gel formulation (type I collagen, heparin/type I collagen, and heparin/chitosan) were mixed with either 0, 10, or 50 microg of BMP-2, making the number of groups nine. The gels were injected into the quadriceps muscles of both legs in 45 rats (n = 10 per group). Freeze-dried formulations of the carriers were also tested with the same amounts of BMP-2 using 15 rats (n = 5 per group). Four weeks after implantation, the quality and amount of newly formed bone were assessed. RESULTS: Chitosan was shown to protect the heparinase-mediated degradation of heparin in vitro. The osteoinductive effects of BMP-2 in combination with heparin/chitosan were superior as compared with BMP-2 implanted together with type I collagen. Interestingly, the heparin/chitosan complex induced a small amount of bone also without BMP-2 added. The heparin/chitosan was completely absorbed after 4 weeks as determined by histologic evaluation, and a normal active bone formation was present. The freeze-dried formulations of the carriers demonstrated similar osteoinductive effects as the gels. CONCLUSIONS: An osteoinductive formula for clinical use is needed for general bone reconstruction. Heparin in complex with chitosan has the ability to stabilize or activate the growth factor in vivo and induce the generation of new bone in good yields.
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| 2. |
- Arnander, Claes, et al.
(författare)
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Three-Dimensional Technology and Bone Morphogenetic Protein in Frontal Bone Reconstruction
- 2006
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Ingår i: Journal of Craniofacial Surgery. ; 17:2, s. 275-279
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Tidskriftsartikel (refereegranskat)abstract
- Osteoinductive bone morphogenetic proteins (BMPs) may be used in humans to facilitate healing of bony defects. The effect of different BMPs is, as with many other growth factors, highly dependent on the delivery vehicle. Bovine type I collagen is currently used in the clinical setting as a carrier and has been approved in several countries for human use. Here, we report the reconstruction of a frontal bone defect using heparin together with bovine type I collagen, hyaluronic acid, and fibrin as vehicles for BMP-2. A bony structure was created on the back of the patient by treating the latissimus dorsi muscle with the growth factor. A polyamide mold was used as a template to achieve the desired shape. The bone structure was transplanted into the defect site via microsurgical techniques. Although the prefabricated bone was not large enough tocover the entire frontal defect, the reconstruction was completed by using an additional cranial implant.
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| 3. |
- Bodin, Ingrid, et al.
(författare)
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Free radial forearm flap reconstruction in surgery of the oral cavity and pharynx: surgical complications, impairment of speech and swallowing.
- 1994
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Ingår i: Clinical Otolaryngology. - 1749-4478 .- 1365-2273. ; 19:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- The first 100 consecutive free radial forearm flaps used in reconstruction for oral and pharyngeal cancer were investigated. Seven re-operations took place due to circulatory impairment of the flap. Two flaps underwent partial, and four total necrosis, one of those patients died of massive haemorrhage. Post-operative infection was significantly correlated to increased time between the last radiotherapy session and surgery. All but eight patients had post-operative impairment of swallowing and all but five patients had impairment of speech articulation or hypernasality. Post-operative time spent in hospital was a range of 12-122 days (mean 37 days). The 2-year survival rate was 70% and the 5-year survival rate was 45%.
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