RU176257U1 - SPACER FOR RECONSTRUCTIVE PLASTIC OF THE CENTURY - Google Patents

Abstract

The utility model relates to medicine, namely to medical devices and is intended for reconstructive surgery on the eyelids.

Spacer for reconstructive plasty of the eyelid, which is a crescent-shaped cartilaginous plate, characterized in that the crescent-shaped cartilaginous plate obtained from the costal cartilage has a width of up to 5 mm, a thickness of up to 1.5 mm, a length of up to 40 mm, a curvature of 7 to 20 mm; at both ends of the plate, at a distance from its edges to 3 mm, two through holes with a diameter of up to 1.5 mm are located for its fixation to the ligaments of the eyelid; the middle part of the plate is wrapped with a silicone-dried amniotic plasticized membrane fixed to it by a U-shaped seam through symmetrical through holes in the membrane and plate with a diameter of up to 0.7 mm; however, free-edge edges up to 5 mm long remain in the silicone-dried amniotic plasticized membrane.

Description

The utility model relates to medicine, namely to medical devices, and is intended for reconstructive surgery for centuries.

Known material for strengthening the lower eyelid, which is a synthetic silicone plate perforated implant with a thickness of 0.5 mm (1). The disadvantage of the implant is the inability to penetrate into it the patient’s tissues due to the solidity of the silicone. This implant is prone to migration. Silicone is a rigid and inelastic material, it must be additionally modeled.

A known implant made of porous polytetrafluoroethylene in the form of a plate 1 mm thick in the form of a tarsal plate (2). The disadvantage of the implant is its frequent rejection in the early or long term after surgery, the occurrence of inflammatory or allergic reactions in the patient.

The known design "Alloplant for skeleton eyelid surgery", which is a dermis with subcutaneous tissue of the foot of a trapezoidal shape (3), obtained by the method (4). The disadvantages of this material include its rapid resorption, non-organotypic tissue regeneration in the plastic area, the occurrence of allergic reactions in the patient.

A cartilaginous autograft in the form of a narrow crescent taken from the back of the auricle is known (5). Its disadvantages include rapid resorption, the need for intraoperative modeling of the material, poor plastic result due to the mismatch of the material in shape and thickness. We have taken this implant as a prototype. The purpose of the utility model is to create material for reconstructive eyelid repair. This goal is achieved by the fact that the crescent-shaped cartilage plate obtained from the costal cartilage has a width of up to 5 mm, a thickness of 1.5 mm, a length of 40 mm, a curvature of 7 to 20 mm; at both ends of the plate, at a distance from its edges to 3 mm, two through holes with a diameter of up to 1.5 mm are located for its fixation to the ligaments of the eyelid; the middle part of the plate is wrapped with a silicone-dried amniotic plasticized membrane fixed to it by a U-shaped seam through symmetrical through holes in the membrane and plate with a diameter of up to 0.7 mm; however, free-edge edges up to 5 mm long remain in the silicone-dried amniotic plasticized membrane.

The costal cartilage is a tissue histologically similar to the tarsal plate of the eyelid, in contrast to the cartilage of the auricle. This material is resistant to resorption, retains its volume, replaces with organotypic regenerate, has sufficient rigidity, performs a supporting function well. The indicated dimensions and shape of the implant provide a good anatomical and functional result. The through holes at both ends of the plate are convenient for fixing it to the ligaments of the eyelid. Silicon-dried amniotic plasticized membrane creates an additional barrier for early resorption of the middle part of the plate. The membrane has good adhesion to the surrounding tissues of the plastic zone and is a stimulator of the growth of new epithelial cells. The presence of free edges of the membrane up to 5 mm allows them to be fixed under the conjunctival tissue to restore the defect of the conjunctiva of the eyelid.

Spacer for reconstructive eyelid repair, which is a crescent-shaped cartilaginous plate obtained from costal cartilage. The plate has a width of up to 5 mm, a thickness of up to 1.5 mm, a length of up to 40 mm, a curvature of 7 to 20 mm; at both ends of the plate at a distance from its edges to 3 mm, two through holes with a diameter of up to 1.5 mm are located for its fixation to the ligaments of the eyelid; the middle part of the plate is wrapped with a silicone-dried amniotic plasticized membrane fixed to it by a U-shaped seam through symmetrical through holes in the membrane and plate with a diameter of up to 0.7 mm; however, free-edge edges up to 5 mm long remain in the silicone-dried amniotic plasticized membrane.

The utility model is illustrated by graphic material. The figure 1 shows the spacer circuit. The cartilaginous plate 1 in the shape of a crescent, has at its edges through holes 2 for fixing to the ligaments of the eyelid. In the middle part of the plate 1 is wrapped with a silicone-dried amniotic plasticized membrane 3, which is fixed to it through symmetrical through holes 4 with a U-shaped seam 5. The silicone-dried amniotic plasticized membrane 3 has free edges 6.

The spacer is used as follows. Before the operation, the patient is assessed for the functions of the eyelid, the necessary dimensions of the spacer are determined to make up for the defect zone. A spacer is placed in the plastic region, fixing it through the through holes at the edges of the cartilaginous plate to the ligaments of the eyelid. The free edges of the silicone-dried amniotic plasticized membrane are fixed under the conjunctival tissue to restore the defect of the conjunctiva of the eyelid.

The use of a spacer is illustrated by a clinical example. Patient N., 65 years old, was admitted to the 2nd department of GBUZ SOKOB them. T.I. Broshevsky 04.04.15 g with a diagnosis of Bazalioma of the skin of the lower eyelid T3 M0 N0. The patient underwent radical full-layer excision of the tumor within healthy tissues, a spacer was placed in the resulting defect in the tissues of the conjunctiva and cartilage of the lower eyelid, and the musculoskeletal defect was closed with a muscular-skin flap. There were no intraoperative complications during spacer fixation. The spacer optimally filled the defect without the need for intraoperative correction of its size and shape. In the postoperative period of migration, exposure of the spacer, allergic reactions in the patient were not observed. The spacer allowed to give the lower eyelid of the patient a sufficient shape and volume, to preserve the lower conjunctival arch. During the control examination after 1, 3, 6 months and 1 year after the operation, the maintenance of a satisfactory shape and volume of the eyelid was noted. The patient was satisfied with the cosmetic result of the plastic.

The spacer for reconstructive plastic surgery of the eyelid can be used both in hospitals of plastic surgery and in ophthalmic hospitals of a wide profile.

Information sources

1. Kataev M.G. "Surgical strengthening of the lower eyelid in plastic anophthalmic syndrome." // Bulletin of Ophthalmology. - 1983 - N3 - S. 58-59

2. Astakhov Yu.S., Nikolaenko V.P., Dyakov V.P. "The use of polytetrafluoroethylene implants in ophthalmic surgery." // S.-P. - Tome - 2007 - 255 S.

3. Muldashev E.R., Salikhov A.Yu., Bulatov R.T. Copyright certificate SU, No. 1524883, cl. A61F 9/00

4. Muldashev E.R. Theoretical and applied aspects of the creation of allografts "Alloplant for plastic surgery of the face: abstract of diss. ... Dr. med. Sciences. - SPb., 1995. - 40 p.

5. Grishchenko SV., Vissarionov et al. / Modern possibilities of free tissue autotransplantation in reconstructive surgery of the eyelids and periorbital region // // Ross. honey. Journal No. 3, 2012. - 23 p.

Claims (1)

Spacer for reconstructive eyelid reconstruction, which is a crescent-shaped cartilaginous plate, characterized in that the crescent-shaped cartilaginous plate obtained from the costal cartilage has a width of up to 5 mm, a thickness of up to 1.5 mm, a length of up to 40 mm, a curvature of 7 up to 20 mm; at both ends of the plate, at a distance from its edges to 3 mm, two through holes with a diameter of up to 1.5 mm are located for its fixation to the ligaments of the eyelid; the middle part of the plate is wrapped with a silicone-dried amniotic plasticized membrane fixed to it by a U-shaped seam through symmetrical through holes in the membrane and plate with a diameter of up to 0.7 mm; however, free-edge edges up to 5 mm long remain in the silicone-dried amniotic plasticized membrane.

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