Use of Banked Tissue in Plastic Surgery

Abstract

The availability of safe and reliable, banked tissues in India has enabled the use of human bone allografts as a viable alternative to autografts in reconstructive surgery. Lyophilised, irradiated bone grafts were used in 2 cases of rhinoplasty, a case of hemifacial atrophy, and as a chin implant.In the patient with revision rhinoplasty the rib graft was resorbed. The patient with hemifacial atrophy developed seroma and infection in the zygomatic and infraorbital area and the rib graft had to be removed. The graft from the same rib that was placed over the mandible was retained well and incorporated completely. The iliac crest cortico-cancellous grafts did well in the second case of augmentation rhinoplasty and in the augmentation of chin.The primary objective of reconstructive surgery in the treatment of burns, non-healing wounds and pressure sores is to remove the dead tissue and restore the continuity of the skin without delay. Lyophilised, irradiated, human amnion is a temporary biological dressing conveniently available off-the-shelf. It was used in twenty four patients with burns, eight patients with bedsores and six patients with non-healing ulcers mainly on the foot. The total surface areas of burns sustained were from 2% to 40%. The burns ranged from second degree to deep third degree burns. Amnion was not used in patients with infected third degree burns.The amnion provided good biological cover in all the patients. It was easy to handle and apply, and provided pain relief. The duration of healing varied depending on the extent and depth of the wound and the amount of exudate. The superficial bedsores healed with a single application of amnion. Reduced exudate, healthy granulation tissue and enhanced epithelisation were observed following application of amnion.

On the origin of amniotic stem cells: of mice and men

“…They showed that burn wound coverage by amnion significantly decreased the bacterial contamination in infected rats. Nowadays, amniotic membranes are efficiently used as allografts for treating skin burns; open and non-healing ulcers; pressure sores; and surgical, infected and traumatic wounds; as well as skin graft donor sites (Andonovska et al, 2008;Branski et al, 2008;Gajiwala and Gajiwala, 2004;Gajiwala and Lobo Gajiwala, 2003;Kesting et al, 2008;Ravishanker et al, 2003;Singh et al, 2004;Singh et al, 2008;Singh et al, 2007;Toda et al, 2007;Wilshaw et al, 2008).…”

Osseotite implants inserted into fresh frozen bone grafts

“…Moreover, autologous bone grafts have the drawback of requiring secondary surgery for autograft retrieval, with increased operation time and anaesthesia, and donor site morbidity [1]. On the other hand, biomaterials are good but expensive, and may become infected at a later date [2]. So, the use of homograft bone provides a reasonable alternative to meet the need for graft material [1,2].…”

“…On the other hand, biomaterials are good but expensive, and may become infected at a later date [2]. So, the use of homograft bone provides a reasonable alternative to meet the need for graft material [1,2].…”

Iliac crest fresh frozen homografts used in pre-prosthetic surgery: a retrospective study

“…Moreover, autologous bone grafts have the drawback of a secondary surgery field for autograft retrieval, with increased operation time and anesthesia, and donor site morbidity. On the other hand, biomaterials are good but expensive, and may extrude at a later date (Gajiwala and Lobo Gajiwala 2003). So, the use of homologue bone provides a reasonable alternative to meet the need for graft material (Vargel et al 2004).…”