Latar belakang: jari pertama memiliki peran yang sangat penting pada fungsi tangan. Rekonstruksi jari pertama jari tangan dapat dilakukan menggunakan jari pertama jari. Jari kedua jari kaki dapat digunakan apabila jari pertama jari kaki tidak dapat digunakan sebagai lokasi donor, misalnya, ketika tingkatan amputasi melebihi dari sepertiga proksimal metakarpal pertama dan diperlukan tulang metatarsal dengan panjang yang signifikan untuk menyediakan ukuran yang cukup pada rekonstruksi jari pertama tangan. Kasus: dilaporkan satu kasus, laki-laki, 24 tahun, datang ke Instalasi Gawat Darurat, Rumah Sakit Dr. Soetomo dengan hilangnya jari pertama jari tangan setelah trauma listrik. Pada pasien telah dilakukan debridemen dan flap lokal pada pergelangan tangan kiri dan skin graft pada tengan kanan. Flap viable dan hangat. Setelah hari ke-5 operasi, graft take 100%, dan pasien bisa kembali ke rumah. Tiga bulan setelah pembedahan, pasien datang ke poliklinik rawat jalan untuk evaluasi. Kondisi jari baik namun pergerakannya terbatas. Kemudian, pada pasien direncanakan untuk rekonstruksi jari pertama dengan transfer jari kedua jari kaki. Hasilnya, evaluasi jari pertama yang baru, dengan keadaan yang baik, dapat bergerak tetapi tidak dapat fleksi dan ekstensi penuh. Simpulan: pilihan rekonstruksi untuk mengembalikan fungsi jari pertama jari tangan termasuk transfer jari kedua jari kaki ke jari pertama jari tangan atau pollicization jari telunjuk. Jari kaki ke jari tangan untuk rekonstruksi jari pertama dapat memberikan hasil yang sangat baik dan tingkat kepuasan pasien yang tinggi.
Highlights: This research compared the hondroregenerative potential between bovine cartilage scaffold with platelet-rich fibrin (BCPRF) and autologous cartilage. The formation of newly-regenerated chondrocyte, the thickness of type II collagen, and the rate of cartilage resorption following the subcutaneous implantation were assessed. BCPRF is highly biocompatible and can be developed as an alternative to alloplastic porous polyethylene (Medpor) implant material. Abstract: The invention of alternative implants with regenerative potential comparable to autologous cartilage continues to be encouraged due to high morbidity of the donor site related to autologous harvesting process. This research attempted an invention of alternative implant using tissue engineering techniques in the form of endogenous regeneration by combining decellularized bovine cartilage scaffold with platelet-rich fibrin (BCPRF) that was implanted subcutaneously. The study aimed to compare the chondroregenerative potential between BCPRF and autologous cartilage in terms of the formation of newly-regenerated chondrocyte, the thickness of type II collagen produced, and the rate of cartilage resorption following the subcutaneous implantation. This study was conducted in a pretest-posttest control group design using New Zealand white rabbits. Forty-eight experimental samples were divided into two groups, then treated with subcutaneous implantation of BCPRF and autologous cartilage respectively. The results were evaluated after six weeks of implantation. Thirty-nine samples were evaluated. There was a significant difference found from both groups in terms of the formation of newly-regenerated chondrocyte, the thickness of type II collagen (p=0.000), and the implant resorption rate (p=0.000). The microscopic images demonstrated a superior chondroregenerative potential in the group receiving implantation of autologous cartilage compared to the group receiving BCPRF. The chondroregenerative potential for autologous cartilage and BCPRF differed significantly in terms of the formation of newly-regenerated chondrocyte, the deposition of type II collagen matrix, as well as the resorption rate.
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