(SANITIZED)UNCLASSIFIED HUNGARIAN PAPERS ON BIOPLAST RESEARCH(SANITIZED)

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP80T00246A018300420001-2
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 33
• Document Creation Date: December 22, 2016
• Document Release Date: November 10, 2011
• Sequence Number: 1
• Publication Date: October 16, 1962
• Content Type: REPORT

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ACTA ORTHOPAEDICA SCANDINAVICA?
Vol. XXX. rase. 4. 1961
FROM THE SANATORIUM FOR TUBERCULOSIS IN THE BONES AND JOINTS,
KAKASSZEK AND TIZE CENTRAL RESEARCH INSTITUTE OF THE BLOOD
TRANSFUSION SERVICE, BUDAPEST, HUNGARY
ARTHROPLASTY USING OF BIOP..AST IN
TUBERCULOUS COXITIS
By
PAL KovAcs, M.D. and M11-IALY GERrNDAS, Ph.D.
In the therapy of articular tuberculosis the aim has for a long time
been to preserve the mobility of joints, but up to recent times there
has not been much chance of success. The advent of anti tuberculotics
raised great hopes also in this sphere and, in fact, the number of
spontaneously healed mobile joints has increased, particularly in cases
where treatment was started early enough. Unfortunalciy. arthroplasty
with the application of metal or synthetic interpositums to promote
mobility did not yield good results and in the literat~7re opinion becamr
general that the use of vitallium or acrylate caps in tuberculosis of
the joints was contraindicated.
The absorbable cap produce(] from fibrin powder by high pressure
represents a significant advance (Fig. 1 ). This synthetic material of
protein named bioplast shows affinity with the tissues, contains no
toxic or carcinogenic substances, and possesses the required con-
sistency and elasticity: more important than any other quality, how-
ever, is its susceptibility to being broken down by proteolytic enzymes
and absorbed. By the aid of chemical pre-treatment. absorption time
can be regulated to take from three or four weeks to seven to eight
months, as required.
The first models were given a trial in the hip joints of (logs by
/,inner, Gerendas, and Rirb ( II ) , and then, on the basis of the results,
in clinical practice. A fibrin cap-fashioned to fit the joint in shape and
size -placed on the femoral head prevents merging ossification of
contiguous articular endings. After operation the cap promotes mobility
of the Iinlb. and under its protection cartilage deveiri~s on the articular
surfaces owing to the influence of function. Finally, six to eight nu>nt'is
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Fig. 1.
13ioplast >.
following implantation---when regeneration has run its course-the
cap is absorbed and disappears without leaving behind any trace. This
circumstance ensures in the most favourable manner free motion of
the joint (2, 3).
Therapy of tuberculous coxitis aimed at restoring motion calls for
consideration of three aspects:
Whether maintenance of, or insistence on, motion involves no danger
of relapse.
Differentiation of cases where mobility is desirable from those where
stable, stiff joints offer an advantage.
The most suitable procedure for obtaining good motion in articular
tuberculosis.
1) Prior to the intr (luction of antituberculotics the view was as
good as unanimous that a tuberculous process can be healed. only by
complete ossification; therefore the objective was to stiffen the joint
at any price. However, observations recorded during the ten years that
have elapsed since initiation of the use of antituberculotics have drawn
attention to many angles that might lead to more complete healing of
tuberculosis in the joints (1, 4, 6, 10).
For several years full recovery and satisfactory motion have been
noted in the treatment of early, superficial, or synovial processes. In
most instances, well-functioning joints have been obtained after eli-
mination of foci and necrectomy. Resection in coxotuberculosis has
also been followed by uneventful recovery, as well as restoration of
good motion within a few months, and the favourable results persist
after the passage of several years. Hence in these cases the maintenance
of motion has exerted no harmful effects on the course of tuberculosis.
Still more encouraging is the fact that the dreaded dangers of former
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times, miliary and meningeal dissemination, have not been encountered
among our more than 3000 cases of osteotuberculosis treated in the
last ten years. It is therefore plausible that we are in favour of restor-
ing motion (7).
2) In our experience, endeavours to retain motion are worthwhile
in every case where the slightness of articular destruction permits hope
of success. If after a time it becomes obvious that the joint shows
functional insufficiency associated with pain and inadequate capacity,
only then is the stabilizing operation performed. To further our efforts
we omit-if possible-the application of plaster and employ intensive
water cure and physiotherapy when tuberculosis has assumed quies-
cence.
3) The literature agrees on the point that arthroplasty with vital-
lium and other prostheses does not produce favourable results and
is thus contraindicated in general (5, 8). However, as evidenced by our
experiences, fibrin caps, too, ensure the maintenance of motion, while
owing to absorption, their use is free from the serious disadvantages
of prostheses; moreover, they contribute to the development of smooth
articular surfaces and are well tolerated by tuberculous tissue.
In 1955 these considerations induced us to begin the use of fibrin
caps in hip resections. So far we have performed twenty operations. The
present paper gives a report on ten cases where the follow-up period
since surgery has been two to three years. The results of later opera-
tions are not evaluated here, but we may remark that they are equally
encouraging.
Our operated cases include five male and five female patients (Table I).
Pretreatment usually takes one to three months. Rest is ensured
by extension, in the presence of severe pain, by plaster. As medicamen-
tous therapy Streptomycin (SM) + isonicotinic acid hydrazide (INH),
or INH + para-anlinosalicylic acid (PAS) are administered in coin-
bination. The object of pretreatment is to obtain regression. If destruc-
tion increases and the joint is threatened by the danger of more exten-
sive destruction, the patient is operated on without delay.
Indication.-Stiffness and limited mobility of the contralateral side
constitute absolute indications for surgery. Apart from these symp-
toms, slight destruction in the.. case of children, young women, and
persons with a sedentary occupation is also regarded as an indication
for surgery. Patients having to perform difficult movements in an up-
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Onset of
Sex disease Diagnosis
f t. years
1. B.J. 8 years boy
2. K.M. 14 years girl
3. B.T. 19 years girl
4. Sz.Zs. 23 years girl
5. B.J. 12 years boy
6. B.L. 16 years boy
7. M.M. 8 years boy
9. F.M. 9 years girl
10. H.E. 32 years woman
'rz Tuberculous colitis, right side
4 Tuberculous colitis, right side
2 Tuberculous coxitis, left side
6 Tubercolous coxitis? left side
1 Tuberculous coxitis, right side
1 Tuberculous coxitis, right side
5 Tuberculous coxitis, right side,
tuberculous spondylitis,
in dorsal vertebrae 8, 9, 10, 11
Tuberculous coxitis, right side
Dislocation of coxa, left side
Tuberculous coxitis, left side
Tuberculous coxitis, right side
'T'uberculosis
Regressive tuberculosis
Caseous tuberculosis
Chronic inflammation
Regressive tuberculosis
Regressive tuberculosis
Regressive tuberculosis
Tuberculosis
Granulation, tuberculosis?
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298 P. KOVACS and M. GERENDAS
right position. fare better with stable, stiff joints. However, final
decision usually depends on surgical findings; in most cases of hip
resection we therefore make preparations also for the use of arthro-
plasty with a fibrin cap.
Surgical Teehnigzze.--Exposure is performed by Smith-Peterson's
incision (9). The diseased articular parts are removed by resection and
the surfaces are shaped as in preparation for plastic surgery with vital-
liunt. Any defects of the head or the articular acetabulum are filled
with "blood cake", chips taken from the hip bone, SCI and penicillin
powder. The "blood cake" is made by mixing of blood from the cavity
and fibrin-thrombin powder. After filling of the defects, the cap is
pulled on the femoral head. If the chief site of infection is in the ar-
ticular acetabulum, a cap of adequate size is placed in the latter and
the head set. In the case of active, suppurative processes, through
drainage is applied and after operation plaster is put on the pelvis
for a period of two or three weeks. Irrigation with a solution of SM +
INH + penicillin is effected daily until the development of secretion
has ceased completely, which generally ensues in four to ten (lays. In
regressive, cicatrizing processes, drainage and plaster are omitted;
preference is given to extension traction.
After-Treatment. Mobilization of the affected limb requires the most
careful individual consideration. Initiation of active and passive move-
ment in bed should rely strictly on clinical, laboratory, and `i-ray
findings. As a rule, perfect rest is observed for two to four weeks, then
physiotherapy is gradually introduced, followed by baths and sub-
aqueous exercise. Usually, the patient begins to move about with
crutches after two or three months, while treatment is continued. The
time for starting unaided movement is determined by the patient's con-
dition and capacity. Antituberculotics are administered during the
whole time of therapy (Table II).
'f'en patients have been followed up for two or three years ('f'able III) i.
The most encouraging results are demonstrated by the fact that the
tuberculous process has healed in all of these ten cases, articular capa-
city is good, the patients use no aid and walk without pain.
Perfect motion has been obtained in three cases; in one case motion
I Our cases are under control at present since five years. They are showing
further improvement. Our new cases are also successful.
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Time
months
Extension
Plaster
13ed rest
mouths
lniliation
of phcsio-
therat)v
bathing
months
Start in
using
bathing
months
Start of
unaided
walking
months
1.
2
plaster
SM. INH
Sept.
15, 19"55
1
1
4
6
2.
3
extension
SM, INH
Oct.
25,
1955
1
1
2?
3
3.
2
extension
SJi, INH
Oct.
20,
1955
1+1
1
8
11
4.
2
plaster
SM, INH
Oct.
25,
1955
1
1
6
8
5.
9
extension
S.11, INH, PAS
Nov. 29,
1955
1
1
2
4
6.
4
extension
SM, INH, PAS
Jan.
10,
1956
1
1
2
3
7.
6
plaster
S.11, INH, PAS
Jan.
12,
1956
1
1
11,2
4
July
8,
1955
Spondylodesis
8.
2
extension
SM, INH, PAS
Febr. 2,
1956
1
1
2
24
9.
6
extension
SM, INH, PAS
Jan. 24,
1957
5
5
6
8
10.
2
extension
SM, INH
April 2,
1957
1
1
2
12
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After operation Tuberculosis
flexion abduction adduction
months
Follow-up
period
years
1.
painful contractura
100
100
100
healed
absent
excellent
6
31/a
2.
absent
30
20
20
healed
absent
excellent
8
31/2
3.
painful contractura
90
100
100
healed
slight
good
24
31%
4.
absent
bone anchylosis
healed
absent
excellent
8
31%s
5.
absent
50
20
20
healed
absent
excellent
6
31%
6.
absent
80
100
100
healed
absent
excellent
12
31/.r
7.
absent
40
20
20
healed
absent
good
6
3
8.
painful contractura
50
50
50
healeiD
absent
improving
24
3
9.
absent
50
10
10
healed
absent
excellent
9
2
10.
painful contractura
90
100
100
healed
slight
good
18
2
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Fig. 2-A. Fig. 2-B.
Fig. 2-A. Radiograph prior to operation. Presence of sequestrum in the acetabulum
is clearly visible at Y cartilage.
Fig. 2-B. Radiograph after one year following operation. The actetabular focus
has been completely filled.
is good, in five satisfactory but not quite complete. In one operated
patient subluxation was followed by anchylosis. Since entire freedom
from symptoms persists, no fresh operation has been undertaken.
For the purpose of illustration, three case records are presented
in detail.
Case No. 1. J.B., a boy lfged 8 years, was admitted on July 13, 1955, with com-
plaints of six months' standing in the right hip joint. At admission a 150? flexion-
adduction contracture was found, causing intense pain on every attempt at motion,
particularly upon abduction, adduction, and extension. The periarthric region was
swollen. A plaster bandage was put on the pelvis and a course of SM+INII treat-
ment started. The general condition improved, but as radiology revealed increased
destruction of the acetabulum (Fig. 2-A), surgery was undertaken on Sept. 15, 1955.
The articular soft parts were found to be cascous, the acetabulum Cartilage was
completely destroyed and at the Y chondrus there was an approximately nut-sized
hone destruction spreading towards the pelvis. The femoral head appeared to be
intact. After complete cleaning of the acetabulum, the surface was reformed and the
acetabular defect scaled with a fibrin cap. Postoperative treatment consisted of
extension and the administration of SM+INH. After a month the process was com-
pensated, thus active and passive physiotherapy was begun in bed and completed by
subaqueous exercises. In the fourth month the patient could use crutches, was free
from complaints, and in the sixth month was able to walk unaided. Since his dis-
charge on May 21, 195(1, we have seen the patient every three months, last time on
January 18, 1959. As shown by radiology, the bone defect has been fully replaced in
one year. Motion is completely fret and painless; capacity is good (Figs. 2-C and D).
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Fig. 2-C. Perfect motion of the right hip restored in six months.
Fig. 2-1). Statically complete function in the right hit).
Case No. 2. L.B., a boy aged 16 years, was admitted on October 20, 1955, with
complaints of 12 months' standing. lie had been given INH+PAS, his abscess had
been tapped several times and he wore a walking machine. At admission the joint
was fixed, a few degrees' motion occasioned severe pain, and at the side over an
area as large as a palm some fluctuation could be suspected. Operation was per-
formed on January 10, 1956. Preoperative radiology (Fig. :3-A) had disclosed an
uneven, constricted articular orifice and small foci in the acctabulum as well as in
the femoral head, with sclerotic environment. Surgical findings accordingly showed
cicatrized granulation and destroyed cartilage. An abscess filled with turbid exudate
was found between the buttocks. Histological investigation confirmed the presence
of regressive tuberculosis. After operation (arthroptasty with fibrin cap) a plaster
bandage was left on for two weeks; extension and SM+I\I1 were employed con-
currently. In a month the patient's condition had greatly improved. Active. passive.
and subaqueous exercises were carried on and some walking with crutelies allowed.
When discharged on April 16, 1956. he could walk ,vitItout crutches, without any
pain; flexion was (30?. Since then he has been seen every three months, the last time
on .January 18, 1959. A year after being discharged, the patient had no complaints
whatever, flexion amounted to 90?, and radiology showed the formation of Cartilage
in the joint (Fig. 3-13). Support was found to be excellent (Figs.:t-(: and I)).
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Fig. 3-A. Preoperative radiograph of right hip. Tbc joint is uneven, constricted,
destroyed, but signs of sclerosing are visible.
Fig 3-B. Radiograph six months after operation. Articular cartilage surface is
developing.
1i L
Fig. 3-C. Fib/. 3-1).
Fig. 3-C. Painless 600 flexion one year after operation.
Fig. 3-D. Statically excellent function in right hip.
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Fig. 4-A.
Preoperative radiograph of pelvis. In the left hip
congenital dislocation of the coxa. Complete ab-
sence of support. On the right, the iliac focus
visible over the outer part of the acctabulum, has
invaded the latter.
Fig. 4-B.
Reverse radiograph of right
hip. The process threatened
to destroy the whole coxa,
therefore surgery was under-
t'"' taken immediately.
Case No. 3. Cy.Sz., a boy aged 15 years, was admitted on November 16, 1955,
with complaints of six months' standing in the right hip. Congenital dislocation of
the left coxa was associated with a '12 cm. shortening and the abscence of static
function (Fig. 4-A). An abscess had developed on the right side. As pre-treatment
we employed S,M+INIi, INII-F PAS, extension, then incision and topical treatment of
fistula and abscess, with SM-{-IN11 solution. Since in reverse radiology the coxa
showed increased destruction of the acetabulum and the femoral head was suspected
of sequestration, we decided on surgery. The operation was performed February 2,
1956. Right side hip joint resection was performed along with iliac necrectomy,
arthroplasty with bioplast, and excision of the fistula. As verified by surgical find-
ings, a green-nut-sized acetabular focus had spread and invaded laterally the joint.
The synovia and the cavity displayed tuberculous (lest ruction. The greater part of
the femoral head was affected together with the cartilage, there was atrophy but no
sign of sequestration. The diseased parts were removed and the articular surfaces
re-formed. When the resulting defects had been filled with a mixture of Sit -{-
penicillin and clotted blood. the fibrin cap was filled on the femoral head. Then, by
a separate incision, the fistula and the abscess were excised to the, line of healthy
tissue. Histological investigation confirmed cascous tuberculosis. After operation a
plaster bandage was applied and SJl--INtl. later [NIT-1-PAS were administered. The
patient showed remarkable inmprovement; in three weeks the plaster was removed,
active and passive physiotherapy was initialed in bed, and subaqueous exercises
were soon added. After two months the patient was allowed to get up and he began
to move about with crutches; by the end of five months all symptoms had vanished
and the hip joint was capable of :10?. painless notion. lie was discharged on .111111'
24, 1956, subsequently reported for follow-up examination every three months and
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AlIT!IROPL:IS'l'Y IN 'f1JR1?IICITIA)US (:()xl'l'IS
Fig. 4-C.
After two years, the
patient walked without
crutches; support is good.
Fig. -I).
Cartilage surface began to develop eight months
following operation.
Fig. 4-F,.
Radiograph taken twenty-four months after opera-
tion. The tuberculous process has been healed, the
cartilage is becoming stronger. The limb is rotated
forward, owing to use and luxation.
continued to take INII+PAS. After the elapse of two years he could walk well
without any crutches, and capacity was good (Fig. 4-C) ; flexion was 40?; abduction,
20?; adduction, 20'. According to radiographic evidence, the process has healed com-
pletely, articular surfaces have developed, but the limb has a rotary position (Figs.
4-D and E). In this case the result of operation is manifested by inhibition of total
articular destruction and by restored motility.
The experience and observations of several years have furnished
proof that by the help of antituherculotics and appropriate, surgical
intervention, articular tuberculosis can be healed, without loss of
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motility by the joint. This applies chiefly to synovial processes and
to cases with slight destruction discovered at an early stage and given
immediate medical care.
Since the year 1955, articular resection complemented with fibrin cap
arthroplasty has been performed in 20 cases of tuberculous coxitis.
A follow-up period of two-three years justifies the statement that
operation is worth while in every case where destruction is slight and
the patient's mode or life calls for restoration of articular motility. The
most significant success achieved by our operations performed to
obtain mobile joints has been the healing of the tuberculous process
in each case. The conditions of such results are as follows:
Surgery should preferably he performed in the regressive stage, at-
tained by two-three months of stabilizing treatment with drugs. If the
process nevertheless shows progression, surgical intervention may be
undertaken earlier in order to save the. joint. However, in such cases
after-treatment has to he cautious, which unfortunately limits the
scope of movement. :-
Use of the fibrin cap in arthroplasty in the presence of tuberculosis
constitutes an advance. The substance is neutral to tuberculosis, does
not give rise to any reaction, and the development of cartilage proceeds
favourably under its protection. Radiography has shown that in three
to six months the developed cartilage can be visualized by X-ray.
The extent of motion depends on the condition of the muscles and
the soft parts, on cicatrization which-unfortunately-- -is marked in
recovery from tuberculosis. This consideration has induced us to avoid
plaster bandages where possible, and to employ them only in the case
of intense pain.
The program of after-treatment is the most essential factor of
therapy and has to he adjusted individually to the patient. Establish-
ment of a schedule prescribing both the period and measure of stabiliza-
tion, exercise, bathing, moving about with crutches, and unaided walk-
ing, demands great circumspection, and has to be supported by clinical,
laboratory, and x-ray investigations. From our experiences in hip re-
section we have drawn the conclusion that in the case of, adherence to
prudent measures, regression may he expected to set in %viLhin four
to six weeks.
Finally, it may be stated that, owing to modern diagnostic and
therapeutic procedures, the healing of articular tuberculosis without
loss of motion is possible and should be exploited to the utmost. Hip
resection combined with use of the fibrin cap is also one of the methods
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serving the purpose of complete restoration in some cases of tuber-
eidous coxitis.
1) The authors report on ten cases of tuberculous coxitis in which
mobile joints were obtained by the use of fibrin caps in hill resection.
2) Those patients have been followed-up for a period of three years.
Judged by healing of tuberculosis and articular capacity, results are
excellent, motility is satisfactory.
3) In every process attended by slight destruction or.upon com-
pelling indication, surgery is recommended, particularly in the case
of children and young women.
4) The fibrin cap does not prevent regression of the tuberculous
process, it ensures mobility, promotes the formation of cartilage and,
after having fulfilled its task, is absorbed and vanishes without leaving
behind any trace.
1) Les auteurs rondent conipte do dix cas de coxite tuberculeuse clans
lesquels it it ete obtenu des articulations mobiles au moyen dune cap-
sule do fihrine clans la resection de la hanche.
2) Ces malades ont etc suivis pendant une pcriode de trois ans. Si
i'on so base sur in gucrison do la tuberculose et la capacity articulaire,
les resultats sort excellents, In mobility est satisfaisante.
3) Dans tous les cas chez lesquels it est question snit Willie 16g6re
destruction, soit (Tune indication peremptoire, l'intervention chirurgi-
cale est reconimandee, en particulier chez les enfants et les jeunes
femmes.
4) La capsule de fihrine n'empcche pas la regression du processus
tuberculoux, rile assure In mobility, favorise la formation do cartilage
et apres avoir rempli sa mission rile est absorber et clisparait sans
laisser aucune trace.
1) Die Verfasser berichten fiber zehn Falle von tuberkuloser Coxitis,
in denen bewegliche Gelenke mitteis der Verwendung von Fibrinkappen
bei der Hiiftgelenlcsresektion erhalten wurden.
2) Diese Patienten wurden wahrend ciner Zeitspanne von drei Jah-
ren bcobachte.t. Hinsichtlich der Heilung der Tuberkulose and der Ge-
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? 0"0 1'. 1\UVALJ atilt .',t.
lenksfunktion warm die Ergcbnissc ausgczcichnct uncl (lie 13cwcglich-
keit war zufric(IcnsE(-llen(l.
3) In ,jc(Icul Prozess, der snit Icichtcr Zerstiirung cinhcrgcht Oder bci
zwingcn(lcr In(1ikation wind der chirurgische Eingriff anhcfolilen, be-
sondcrs bei Kin(lcrn ((Iti' jungen Fraucn.
4) 1)ic Fibrinkaltltc vcrhin(lcrt (las Zuriickgehcn des tuberkuliisen
Prozesses nicht, sic sichert die Bcwcglichkcit, hefordert (lie Knorpelbil-
(lung and Nvird resorbicrt nachdcnl sic ihre Aufgahc vollfiihrt hat ohne
irgend cinc Spur zu hintcrlasscn.
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licilagenheft. (Symp. Semmering). 1956.
2. Geren(lds,.11.: Surgical Application of Synthetic Substances and Iiioplasts. Acta
Morph. Bung. Suppl. 1'Il. 25 (1956).
Gerendds,.11.: Bioplastc and ihrc Anwend(mgsgehiete. Therap. Ilung. 7, 6 (1959).
3. Gerendds, .11. S. Biro, T.: Bioplastc and ihrc klinisehe Anwendung. IV. Intern.
Hongr. Biochem. Wien, Pcrgamon Press London 175 (1958).
4. Ileinze, R.: Kunststoffe in der Medizin..J. A. Barth, Leipzig, 1955.
5. Jadet, J. & Judet, R. J.: The Use of an Artificial Femoral Head for Arthroplasty
of the Hip Joint. Journ. of Bone and Joint Surg. Bd. 32/B. S. 166 (1950).
6. Kastert,.1.: Neuc Behan ilungsmethode der Coxitis The. Langenbecks Archiv trod
Zschrft. fiir Chir. 13. 282 (1955).
7. Koudes, 1'.: Fibrinkupakkal vegzett arthroplastica coxitis tbc.-ben. (Arthroplasty
performed with Fibrin Cap in Tuberculous (Coxitis). All. Fodor Jbzsef The.
Gycigyintuet Kiizlemdnyei, Budapest, I. 1956.
8. Schoch,.1.: ZunY%hentigen Stand der Endoprothesenplastik der Hiiftc nach .1t1det.
Z. Orthop. 88 B. 502 (1957).
9. Smith-Petersen, Dl. N.: Approach to and Exposure of the iiip Joint for Mold
Arthroplasty.Journ. of Bone and Joint Surg. 31-A, 40 (1949).
10. Wilkinson, 31. C.: Partial Synovectomy and Curettage in the Treatment of Tuber-
culosis of the Hip. Journ. of Bone and Joint Surgery. 39-B, 66 (1957).
11. /.inner, N., Gerendds, M. S. Bird, T.: A New Method of Arthroplasty. Acta Med.
Acad. Sci. Hung. 7, 217 (1955).
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U 1e11yo(11at
HAEM ..", '?II.,OGIA HUNGAHICA
' 1L:S ]L. li ase'1 ; 't1?iS 2.
196 .. evi szanab?1
r
Az Orszagos Vertranszfuzios Szolgalat Kozponti Kutato Intezet
kiadvanya, Budapest.
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Tapasztalataink bioplaszt keszitinenyekkel
DOCZY AGNES
Orszagos Vertranszf6zi6s Szolgalat Kozponti Kutat6 Intezete, Budapest
A sebeszetben - foleg plasticai muteteknel - egyre nagyobb teret
kapnak a kiilonfele, prothesisktnt alkalmazott muanyagok. Ezen mutetek-
nel azonban sokszor igen fontos kovetelmeny, hogy az alkalmazott anyag
csak ideiglenesen maradjon a beiiltetes helyen. Erre a celra szolgalnak az
altalunk eloallitott lin. bioplastok, melyek fibrinbol - tehat testazonos
anyagbol - kesziilnek. Az anyag jellemzo tulajdonsaga, hogy a szoveti
fermentek hatasara lebomlik es felsziv6dik1, tehat reoperaci6val va16
eltavolitasa feleslegesse valik (1. abra).
CH
NH
O-C
HC
OcHN
C=0
CH
CH2
CH
CH2
HO