Tonisav Antoljak

Effects of ozone on howwell split-thickness skin grafts according to Thiersch take in war wounds

In a prospective study on 35 wounded persons we examined the effects of ozone on howwell split-thickness skin grafts took in war wounds. Each of the 35 wounded persons hat at least two similar gunshot wounds, one on the lower leg or forearm and the other on the upper leg or upper arm. During the first 10 days all wounds were treated with 10% NaCl water solution dressings until the moment when healthy granulations were observed. Thereafter, the defects were covered with split-thickness skin grafts according to Thiersch. For technical reasons we treated grafts on the lower leg and forearm with ozone following the usual scheme. Grafts on the upper leg or upper arm were treated in the conventional way and they served as a control group. The results obtained in the group followed up are presented by percentage of graft takes after 10 days and accordingly compared with the results obtained in the control group. There was a higher percentage of takes in ozone-treated split-thickness skin grafts. More than 74.3% of the split-thickness skin grafts treated with ozone had a take of more than 75% of the covered surface as apposed to only 40% of the grafts treated with the conventional method. The results in these two groups were compared with a chi square matched pair test. Difference in take of the skin grafts in these two groups was statistically significant at P < 0.01.ZusammenfassungDiese prospektive Studie erforscht den Einfluß des Ozons auf die Aufnahme freier Hauttransplantate bei Kriegswunden. Sie beruht auf Ergebnissen, die bei der Behandlung von 35 Verwundeten erzielt wurden. Jeder Verwundete wies mindestens 2 ähnliche Schußwunden auf: eine Kniebeugen- bzw. Unterarmwunde und eine Oberschenkel- bzw. Oberarmwunde. 10 Tage vor der Bildung gesunder Granulationen wurden in hipotonische Lösung getränkte Umschldge auf alle Wunden gelegt. Anschließend wurde an den betroffenen Stellen die Transplantation nach Thiersch vorgeführt. Aus technischen Gründen behandelte man Kniebeugen- bzw. Oberarmtransplantate nach dem althergebrachten Verfahren. Die Kontrollgruppe bildeten Unterarm- und Oberschenkeltransplantate. Am 10. Tag der Behandlung wurden die Ergebnisse verglichen. Die Untersuchungsgruppe wurde mit der Kontrollgruppe bezüglich der Annahme des Transplantats durch das Gewebe verglichen. Es zeigte sich, daß das Gewebe die mit Ozon behandelten Transplantate statistisch gesehen wesentlich besser annahm (ξ2-Test, P<0,01). Wdhrend bis zu 74% der mit Ozon behandelten freien Hauttransplantate über 75% der Hautoberfläche angenommen wurden, betrug dies für die nach der konventionellen Methode behandelten Transplantate nicht mehr als 40%.

Intraoperative measurement of bone electrical potential: a piece in the puzzle of understanding fracture healing

INTRODUCTION Bone electrical potentials change with the force applied. Also, fracture alters the bone electrical potential, so it becomes more electronegative. These potentials have an important role in fracture healing, bone growth and remodelling. Literature data on the influence of fracture operative treatment on bone electrical potentials, and possible consequences of this influence, are sparse. The objective of this study was to establish a method of intraoperative bone potential measurement, and to try to find a correlation between electrical potential and fracture type, osteosynthesis method and prognosis. PATIENTS AND METHODS 52 patients with a pertrochanteric fracture were included in the study. Bone electrical potentials were measured intraoperatively using a thin Kirschner wire introduced through bone cortex at the selected point and pointed to opposite cortex, not penetrating it. Kirschner wires were connected using clamps to multimeter (YF-78 Multimeter) device. Neutral electrode (inductive rubber) was placed behind ipsilateral gluteus. RESULTS Near the fracture site potentials of -199 up to -267 mV were recorded. Mean measured potential of bone plate after fixation was -240 mV. Bone potentials correlated with the subtype of fracture and early mobilisation of patients. CONCLUSIONS Bone potentials, caused by fracture, can be measured intraoperatively; the operative procedure appears to influence their generation. Measured potentials depend on the fracture type, and could be correlated with prognosis.