Application of Pigskin Transplantat for the Elimination of Orinasal Connection: a Clinical Case

Nahirniy Ya. P., Hooda N. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

In recent years, the clinic dental surgery, there are many patients with osteomyelitis of the mandible that are occurring against a background of reducing reactivity. The destruction of bone that accompanies osteomy­ elitis of the maxilla in patient who use narcotic drugs also leads to the formation of the palate defect. In such cases, the food and the air from the mouth begin to get into the nose, and it becomes specific. Plastic closing of such de­ fects is very difficult. In most cases, a local plastic tissues or in case of inability to use plastic by Filatov stem. But in practice the result of the operation is often unsuccessful. The reasons may be particular structure of the mucosa in the area of the defect, which reduces its regenerative capacity, reduced blood supply to the flap when it is moving, technical difficulties during the operation and so on. In the dental department of the Ternopil University Hospital applied to remedy the defect palate using the transplant of pig skin as a membrane thickness of 1.5 mm, which is placed under the mucous membrane in the region of the defect, closing it. The lyophilized pigskin registered in Ukraine and is permitted for use as medical devices product. The transplant is used as a conductor, which forms the epithelization of the wound, and isolates the mouth of the nasal, which greatly improves the state of the patient in the postoperative period. Clinical case. Patient D. (41 years, medical history number 02/05378) addressed in the clinic dental surgery of Ternopil University Hospital with complaints about the defects in the right area palate and getting food in the nose. In history: Hepatitis C infection, the diagnosis have been found in Ternopil Infectious Diseases Hospital. Patient was treated inpatient in the dental department in 2009 with a diagnosis of destructive osteomyelitis of the upper jaw and mandible on a background of drug abuse, infectious hepatitis C, remission. The sequestrectomy operation on the upper and lower jaws was carried 24.12.2009 p. The postoperative period was uneventful, the wound healed by secondary intention. The patient was discharged in the satisfactory state, the 05.02.2010 (history number 02/12149). But about a year ago there was a defect in the palate, therefore, 22.05.2013, the patient re­entered in the dental department of the Ternopil University Hospital. Objectively: the general condition of the patient is satisfactory. On examination of the maxillofacial area observed asymmetrical face due to deformation of the upper and lower jaws. Local Status: during the inspection of the oral cavity detected a defect in palate right size 1. 2 x 0.8 cm at the level of missing molars. The mucous membrane in the area of the defect was thinned, pale. Diagnosis: orinasal combination in the area of palate on the right. Surgical intervention conducted as plastic defect using the transplant of pig skin. The protocol operations: two autopsies the mucosa to the bone in the area of the defectis carried out under local infiltration anaesthesia: the cut parallel to the edge of the defect, departing from it by 0. 7­0.8 cm, and the cut on the edge of the defect. Mucous­ periosteum piece of appropriate size the cut A peeled, coming on the opposite side of the edge of the defect at 0. 7­0.8 cm. The transplant of pig skin, thickness 1. 5 mm, in the form of a plate placed in the cut. To facilitate the introduction of pre­transplant his take on a silk ligature. The transplant is fixed, 2­3 silk sutures impose on the cut. The postoperative period was uneventful. The transplant of pig skin played the role of conductor through which passed epithelization of the wound. The patient was examined after three months. The defect in palate was not measured, the mucous membrane was pale pink. The proposed method can be applied in liquidation palate defects different genesis.

orinasal combination, plastic, pigskin transplantat

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«Bulletin of problems biology and medicine» Issue 3 part 2 (111), 2014 year, 195-197 pages, index UDK 616.315­007.253­089. 844:591.477:599. 731.1­035.51