Fibrin Sealants in Orthopaedic Surgery

Abstract

Due to its considerable systemic impact, several local and general methods to control surgical ( intra/perioperative) bleeding have been developed, with particular characteristics adapted to each type of surgery. In orthopaedic procedures, elective or urgent, bleeding is to be seriously considered , since usually both bones and soft tissues are injured or cut, so adapted haemostatic means have to be used. This issue is of particular importance especially when very small vessels are involved, and especially on large surfaces, since ligation or cauterization are useless in these situations. An effective tool in these circumstances is the group of fibrin sealants, which can stop diffuse bleeding on surfaces when produced by very small vessels. The authors present their clinical experience with fibrin sealants, underlining the indications and the limits of the method.

Effect of Osteoplasty with Bioactive Glass (S53P4) in Bone Healing - In vivo Experiment on Common European Rabbits (Oryctolagus cuniculus)

“…The present studies results are in concordance with the literature. Many studies deal with the antibacterial characteristic of bioactive glass S53P4 and shows that this biomaterial can heal osteitis and can reduce the grade of bone infections [25][26][27]. The authors of the present study did not observe any cartilage formation or any adverse round cell tissue reactions during the histopathological examinations.…”

S53P4 Bioactive Glass - an Alternative Treatment of Bone Defects

“…From a biological point of view, the Bioactive Glass is a promising solution for filling post-osteomyelitis, traumatic or other bone defects [29]. It has anti-microbial, osteoconductive and angiogenic properties [9,12,17,29]. In contact with body fluids bioactive glass works by leaching out ions (in our study BonAlive generates Na, Ca, Si and P ions) leading to an alkaline environment (high pH) and increased osmotic pressure.…”

“…In this specific configuration, patients are protected from infections, excessive bleeding and are expected to have a faster recovery. From a biological point of view, the Bioactive Glass is a promising solution for filling post-osteomyelitis, traumatic or other bone defects [29]. It has anti-microbial, osteoconductive and angiogenic properties [9,12,17,29].…”

“…To our knowledge, in Romania there is limited scientific work involving the Bioactive Glass and the existing approaches are mainly in vitro experiments such as [26][27][28]. So far, the only Romanian clinical initiative of treating bone infections using the Bioactive Glass has been recently reported by [29] with promising results. However, the clinical work involving Bioactive Glass implants for treating bone defects and especially defects in load-bearing bones is far from mainstream in Romanian hospitals.…”