Dr. Ting Wang, A Leader of Asian Plastic Surgery

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Comparing bone implant to rib cartilage

Is the bone implant material really higher than the autogenous rib cartilage?

In the recent past,the bone implant materials, represented by donor allogeneic cartilage, have become increasingly popular and are often used in cosmetic surgery especially rhinoplasty. The traditional autologous rib cartilage from the patient's body has always maintained a good reputation, except for a slightly higher bending rate, it is generally recognized that its anti-infection, histocompatibility is excellent. It is natural to think that similar sources of bone implant materials will have similar properties. But some recent cases of infection have aroused great concern and panic among students.

For the Ming medical Exchange, as the earliest extensive use of the time-tested autogenous rib cartilage material to carry out rhinoplasty surgery, we also because it can avoid the extra incision, simple surgery, and the use of allogeneic cartilage this material. But the latter clinical process of slightly higher absorption rate and individual infection, which has aroused our attention. Medical quality is the core content of hospital survival and development, patient safety is the eternal theme of medical Service, the spirit of "seeking truth from facts, serious and responsible" principle, Ming medical Hui Wang boat Dean traced, specially to the United States bone implant materials Factory did a detailed investigation.

Tracing the origin of the United States Layers of "good bones"

First of all, a large number of applications of the same bone implant materials in the United States, Germany, Korea, the majority of the screening process specifications, a long history of technology, clinical practice data rich, can provide better anti-infection. In particular, some brands from the United States, its stability is better than other products in the market. Another type of new development for the domestic and Up-and-comer, has a sound domestic product registration information, absorbing a lot of advanced technology in the developed countries, but in the donor screening, technology still has to improve the space, in the process of continuous improvement.

As an example, LifeNet, the second largest non-profit body tissue bank in the United States, which was visited by Dr.Wang Ting has the same rigorous screening of implanted materials, in addition to more complex transplant organs such as cardio-pulmonary liver and kidney. Starting with a database of donated volunteers registered by traffic management departments in the United States, we screened the volunteers ' lifestyle, behavior habits, exposure risk, disease history, etc. From the already screened pathogens, no tumor donor, continue to carry out the acellular, antigen (immune), plus such as high dose gamma ray irradiation and other further eliminate the residual cell activity, effectively eliminate pathogens, and then put in a sterile environment packaging preservation. Therefore, it avoids carcinogenicity, and basically eliminates the problem of rejection of infection.

On the other hand, as per the case data collection by the medical exchange in the Ming Dynasty, the rate of infection of the same bone implant material in our imported materials was not significantly higher than that of autogenous bone in the case of indications and reasonable treatment. Rusell W.H Kridel, a foreign cosmetic specialist, published a paper in the journal Arch Facial Plast Surg that the same bone implants were used in nasal carving surgery, and the proportion of infections was similar to that of autologous costal cartilage (0.87%). This article also basically reflects the combination of clinical and practical.


It should be noted,however, that some patients may not necessarily be suitable for mass use of the same material, such as:
 
1.The Operation area was originally unknown, not absorbable surgical implantation or injection of material.
 
2.The local experienced many operations, scars heavier, so the blood vessels and immune function is also significantly impaired.

3.The region of the operation often has hair follicle inflammation, acne, acne, these already existing local infection, in the choice of allograft bone, to be more cautious, need additional preventive measures.

Infection factors Full control of infection from other angles

As the leading position in the domestic nasal plastic surgery, Dalian Medical Beauty Hospital, has been making serious efforts  trying to establish the field of nasal plastic standardization system and technical standards, forming a standardized process.

Using the opportunity of visiting the Presbyterian Hospital of Columbia University (Columbia University Prebyterian Hospital), Wang was able to understand and refer to the experience of American hospitals in controlling nosocomial infections, Further according to our actual situation put forward more perfect solution:

1.Before the operation of the strict screening of customers, usually with upper respiratory tract infection, the local hair follicle inflammation, acne, are recommended for treatment in advance to cure, smoking and wine habits, a large number of daily smoking, and strongly recommend quitting smoking, abstinence alcohol. For patients near the menstrual period, scheduled for elective surgery. Optimize the service process, shorten the patient waiting, eliminate cross infection opportunities.


2.Improve the operation process, in strict accordance with the aseptic operation process, the air, the goods strict detection, the surgeon on the upper respiratory tract, hand and operating room items surface disinfection situation closely monitored and strict treatment, regular air and bacteria culture.
 
3.Closely monitor the access to the operating room in the presence of upper respiratory tract infection, tracking the changes in hospital infection trends, effective isolation bacteria staff.
 
4.Strengthen the supervision and disinfection of the details, screening of suspicious consumables, the implementation of disinfection measures.

5.Optimize and improve the procedure, technique and operation skill of the comprehensive rhinoplasty, optimize the procedure, and shorten the operation time obviously.
A series of methods for postoperative infection control were developed. 
 
6.The standard of artificial plastic prosthesis materials used in the operation of the procedures and non-contact use techniques.


By strengthening the scientific and rational control and management of each link in the operating room, we can reduce the infection rate and effectively control the postoperative infection.Through monitoring,urging all levels of personnel to strictly implement the rules and regulations,really effectively reduce the indirect infection,the hospital infection control and management work into a scientific management track.