fibrin sealant

纤维蛋白密封剂
  • 文章类型: Journal Article
    重组肉制品是提高材料利用率和经济效益的一种方法。在这种结合肉块或颗粒形成较大肉块的过程中,用于粘合重组肉的添加剂和加工技术在肉的结构和外观形成中起着至关重要的作用,同时减少营养和水分流失并增强风味。本研究综述了肉类重组技术中常用的粘合剂,包括转谷氨酰胺酶,葡萄糖酸-δ-内酯,纤维蛋白,明胶,和凝胶乳化剂,如亲水胶体,磷酸盐,淀粉,和纤维素。此外,加工技术,如高压,超声波,真空辅助,微波炉,讨论了三维打印,强调他们的原则,属性,功能,和安全。该研究进一步总结了各种粘接技术在重组肉中的应用和研究进展。它分析了优势,挑战,这些技术的发展前景,为该领域的进一步研究提供支撑。
    Restructuring meat products is one way of improving material utilization and economic efficiency. In this process of combining meat pieces or granules to form larger pieces of meat, the additives and processing techniques employed in bonding the restructured meat play crucial roles in the formation of the structure and appearance of the meat while simultaneously reducing nutrient and water loss and enhancing flavor. This study reviews the adhesives commonly used in meat recombination technology, including transglutaminase, glucono-delta-lactone, fibrin, gelatin, and gel emulsifiers such as hydrophilic colloid, phosphate, starch, and cellulose. Additionally, processing technologies such as high-pressure, ultrasonic, vacuum-assisted, microwave, and three-dimensional printing are discussed, with emphasis on their principles, properties, functionalities, and safety. The study further summarizes the application and research progress of various bonding techniques in restructured meat. It analyzes the advantages, challenges, and development prospects of these techniques to provide support for further research in this field.
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  • 文章类型: Journal Article
    神经损伤由于其普遍发生和重大影响而在医学领域内提出了实质性挑战。在神经损伤中,一系列生理病理和代谢反应发挥作用,以稳定和修复由此产生的损害。一个关键的问题是神经肌肉接头处的连接中断,导致严重的退化和肌肉功能的大量丧失,从而阻碍了运动任务。虽然端到端神经吻合术是治疗周围神经损伤的既定技术,实现全面的形态功能恢复仍然是一个巨大的挑战。为了提高修复过程,正在探索替代和支持方法。一个有希望的候选是利用异源纤维蛋白生物聚合物,没有人体血液成分的密封剂。值得注意的是,这种生物聚合物已经展示了其在多种再生医学使用场所建立稳定和保护性微环境的能力。因此,本研究旨在评估将异源纤维蛋白生物聚合物与神经吻合治疗神经损伤的效果。借鉴先前通过PubMed/MEDLINE传播的研究结果,Scopus,和WebofScience数据库。进一步的论述深入探讨了神经肌肉接头生物学的复杂性,神经损伤病理生理学,以及更广泛地利用纤维蛋白封闭剂和缝合线进行神经重建手术。异源纤维蛋白生物聚合物与神经吻合的联系成为克服传统封闭剂相关限制的潜在途径,同时减轻神经退化。肌肉,和NMJ受伤后,从而为随后的再生培养更有利的环境。的确,人们对这种方法的长期再生潜力及其在人类神经损伤重建手术中的适用性提出了质疑。
    Nerve injuries present a substantial challenge within the medical domain due to their prevalent occurrence and significant impact. In nerve injuries, a range of physiopathological and metabolic responses come into play to stabilize and repair the resulting damage. A critical concern arises from the disruption of connections at neuromuscular junctions, leading to profound degeneration and substantial loss of muscle function, thereby hampering motor tasks. While end-to-end neurorrhaphy serves as the established technique for treating peripheral nerve injuries, achieving comprehensive morphofunctional recovery remains a formidable challenge. In pursuit of enhancing the repair process, alternative and supportive methods are being explored. A promising candidate is the utilization of heterologous fibrin biopolymer, a sealant devoid of human blood components. Notably, this biopolymer has showcased its prowess in establishing a stable and protective microenvironment at the site of use in multiple scenarios of regenerative medicine. Hence, this scoping review is directed towards assessing the effects of associating heterologous fibrin biopolymer with neurorrhaphy to treat nerve injuries, drawing upon findings from prior studies disseminated through PubMed/MEDLINE, Scopus, and Web of Science databases. Further discourse delves into the intricacies of the biology of neuromuscular junctions, nerve injury pathophysiology, and the broader utilization of fibrin sealants in conjunction with sutures for nerve reconstruction procedures. The association of the heterologous fibrin biopolymer with neurorrhaphy emerges as a potential avenue for surmounting the limitations associated with traditional sealants while also mitigating degeneration in nerves, muscles, and NMJs post-injury, thereby fostering a more conducive environment for subsequent regeneration. Indeed, queries arise regarding the long-term regenerative potential of this approach and its applicability in reconstructive surgeries for human nerve injuries.
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  • 文章类型: Journal Article
    80多年前最初描述的Tarlov囊肿被认为是病因和临床意义不确定的解剖学变体。它们通常在常规腰骶成像中检测到,通常在鉴别诊断中没有报告。越来越多的证据表明,至少有一些Tarlov囊肿是有症状的,可能对患者的健康和福祉产生重大不利影响。妇女受到这种情况的影响尤其严重,经常表现为长期疼痛和神经功能障碍。严重的性别偏见一直是这些患者管理中的一个问题。不幸的是,对于有症状的Tarlov囊肿的患者选择或治疗方法尚无共识.这篇综述文章更新了患病率的信息,诊断,临床意义,以及这些囊肿的治疗。根据这些发现和1000多名患者转诊的经验,我们构建了有症状的Tarlov囊肿的治疗决策算法,为这些复杂囊肿患者的适当治疗提供指导.
    Tarlov cysts were thought to be anatomic variants of uncertain etiology and clinical significance when initially described over 80 years ago. They are often detected in routine lumbosacral imaging and generally not reported in a differential diagnosis. There is increasing evidence that at least some Tarlov cysts are symptomatic and can have a significant adverse impact on patients\' health and well-being. Women are disproportionately affected with this condition, often presenting with long-standing pain and neurological dysfunctions. Significant gender bias has been a concern in the management of these patients. Unfortunately, there is no consensus on patient selection or management approaches for symptomatic Tarlov cysts. This review article updates information on the prevalence, diagnosis, clinical significance, and treatments of these cysts. Based on these findings and experience with over 1000 patient referrals, a treatment decision algorithm for symptomatic Tarlov cysts was constructed to provide guidance for appropriate management of patients with these complex cysts.
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  • 文章类型: Journal Article
    最近在几个外科专业中对纤维蛋白密封剂进行了彻底的研究;然而,结果是矛盾的。我们旨在检查患有甲状腺切除术的纤维蛋白密封剂患者的安全性和有效性。一个彻底的,使用PubMed使用术语“甲状腺切除术”和“纤维蛋白密封剂”进行了系统的文献检索,科克伦图书馆,和Clinicaltrials.gov,2022年12月25日。这篇综述感兴趣的主要结果是排水量,而住院治疗,排水保持的长度,暂时性发声障碍是次要结局.我们的荟萃分析(n=249)表明,纤维蛋白密封剂的应用与较少的总引流有关[SMD-2.76(-4.83,-0.69);P=0.009;I297%],但不与引流保留时间[SMD-2.35(-4.71,0.01);P=0.05;I298%],住院时间[SMD-1.65(-3.70,0.41);P=0.12;I297%],短暂性发声障碍[RR1.01(0.27,3.82);P=0.99;I20%]。系统评价发现,在甲状腺手术中使用纤维蛋白密封剂对总引流量呈阳性,但与引流保留时间无关。住院时间,和短暂性发音障碍.值得注意的是,这种解释因不均匀而变得复杂,偶尔低于标准的技术和试验报告,根据这篇系统综述的发现。
    Fibrin sealants have recently been thoroughly studied in several surgical specialties; however, results are conflicting. We aimed to examine the safety and efficacy of fibrin sealant patients having thyroidectomies. A thorough, systematic literature search was carried out using the terms thyroidectomy and fibrin sealant using PubMed, Cochrane Library, and Clinicaltrials.gov on December 25, 2022. The primary outcome of interest in this review was the amount of drainage, whereas hospitalization, the length of drain retention, and temporary dysphonia were secondary outcomes. Our meta-analysis (n = 249) showed that application of fibrin sealant is associated with lesser total drainage [SMD -2.76 (-4.83, -0.69); P = 0.009; I2 97%], but not with retention time of drainage [SMD -2.35 (-4.71, 0.01); P = 0.05; I2 98%], hospitalization time [SMD -1.65 (-3.70, 0.41); P = 0.12; I2 97%], and transient dysphonia [RR 1.01 (0.27, 3.82); P = 0.99; I2 0%]. The systematic review found that the use of fibrin sealant in thyroid surgery is positive in total volume drainage but not with the retention time of drainage, hospitalization time, and transient dysphonia. It is notable to remember that this interpretation is complicated by uneven, occasionally subpar technique and trial reporting, according to this systematic review\'s findings.
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  • 文章类型: Journal Article
    纤维蛋白,来自参与血液凝固的蛋白质(纤维蛋白原和凝血酶),是一种在健康领域有不同应用的生物聚合物,因为它有止血作用,生物相容性和三维物理结构特性,并且可以用作组织再生或细胞和/或生长因子的药物递送系统中的支架。纤维蛋白单独或与其他生物材料一起,已被证明可用作促进干细胞再生的生物支持,骨头,周围神经,和其他受伤的组织。由于其适用形式和构成形式的多样性,有富血小板纤维蛋白(PRF),富白细胞和富血小板纤维蛋白(L-PRF),纤维蛋白胶或纤维蛋白密封剂,和水凝胶。为了增加纤维蛋白的性质,可以结合辅助治疗来促进组织修复,如光生物调节(PBM),通过低水平激光治疗(LLLT)或LED(发光二极管)。因此,本系统综述旨在评估PBM与纤维蛋白化合物使用之间的关系,参考发表在PubMed/MEDLINE上的先前研究的结果,Scopus和WebofScience数据库。使用了“纤维蛋白和低水平激光治疗”和“纤维蛋白和光生物调节”的描述符,不限制出版时间。书目搜索在PubMed/MEDLINE中找到了44篇文章,其中26人因两面性或超出资格标准而被排除在外。我们还在WebofScience上找到了40篇文章,并选择了一篇文章,152篇Scopus文章,没有选择任何文章,共19篇进行定性分析。与PBM组合使用最多的纤维蛋白类型是纤维蛋白密封剂,主要是异源的,其次是PRF或L-PRF。在PBM中,镓-铝-砷化物(GaAlAs)激光器盛行,波长为830nm,其次是810nm。在临床前研究中,研究最多的纤维蛋白和PBM的关联是在骨或神经损伤中使用纤维蛋白封闭剂;在临床研究中,PBM与药物相关治疗颌骨坏死(MRONJ)的关系。因此,有科学证据表明PBM对纤维蛋白复合材料的贡献,构成一种通过刺激细胞活性起作用的辅助疗法,血管生成,成骨细胞激活,轴突生长,抗炎和抗水肿作用,增加胶原蛋白的合成和成熟,以及生物分子。
    Fibrin, derived from proteins involved in blood clotting (fibrinogen and thrombin), is a biopolymer with different applications in the health area since it has hemostasis, biocompatible and three-dimensional physical structure properties, and can be used as scaffolds in tissue regeneration or drug delivery system for cells and/or growth factors. Fibrin alone or together with other biomaterials, has been indicated for use as a biological support to promote the regeneration of stem cells, bone, peripheral nerves, and other injured tissues. In its diversity of forms of application and constitution, there are platelet-rich fibrin (PRF), Leukocyte- and platelet-rich fibrin (L-PRF), fibrin glue or fibrin sealant, and hydrogels. In order to increase fibrin properties, adjuvant therapies can be combined to favor tissue repair, such as photobiomodulation (PBM), by low-level laser therapy (LLLT) or LEDs (Light Emitting Diode). Therefore, this systematic review aimed to evaluate the relationship between PBM and the use of fibrin compounds, referring to the results of previous studies published in PubMed/MEDLINE, Scopus and Web of Science databases. The descriptors \"fibrin AND low-level laser therapy\" and \"fibrin AND photobiomodulation\" were used, without restriction on publication time. The bibliographic search found 44 articles in PubMed/MEDLINE, of which 26 were excluded due to duplicity or being outside the eligibility criteria. We also found 40 articles in Web of Science and selected 1 article, 152 articles in Scopus and no article selected, totaling 19 articles for qualitative analysis. The fibrin type most used in combination with PBM was fibrin sealant, mainly heterologous, followed by PRF or L-PRF. In PBM, the gallium-aluminum-arsenide (GaAlAs) laser prevailed, with a wavelength of 830 nm, followed by 810 nm. Among the preclinical studies, the most researched association of fibrin and PBM was the use of fibrin sealants in bone or nerve injuries; in clinical studies, the association of PBM with medication-related treatments osteonecrosis of the jaw (MRONJ). Therefore, there is scientific evidence of the contribution of PBM on fibrin composites, constituting a supporting therapy that acts by stimulating cell activity, angiogenesis, osteoblast activation, axonal growth, anti-inflammatory and anti-edema action, increased collagen synthesis and its maturation, as well as biomolecules.
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  • 文章类型: Journal Article
    几十年来,已经采取科学的努力来制定策略和医疗辅助手段,以减少肠道手术后吻合口并发症。尽管如此,吻合口漏(AL)是一种经常发生的术后并发症,对健康造成严重后果,生活质量,和经济方面。使用基于胶原蛋白和/或纤维蛋白的密封剂覆盖肠吻合的方法已显示出对减少泄漏的有希望的效果;然而,它们还没有达到常规使用。评估用胶原和/或纤维蛋白基封闭剂覆盖肠吻合对术后渗漏的影响,我们进行了系统评价和荟萃分析.
    PubMed,WebofScience,科克伦图书馆,和Scopus(1964年1月1日至2022年1月17日)进行了搜索,以确定研究用胶原蛋白和/或基于纤维蛋白的密封剂涂覆任何肠吻合对术后AL的影响的研究,再操作率,Clavien-Dindo严重并发症,死亡率,和住院时间。计算具有95%置信区间(CIs)的集合比值比(ORs)。
    总的来说,15项研究(5项随机对照试验,三项非随机干预研究,6项观察性队列研究)纳入干预组1,387例患者和对照组2,243例患者.使用固定效应荟萃分析(I2<50%),涂肠吻合术患者的AL率显着降低(OR=0.37;95%CI0.27-0.52;p<0.00001),再手术率(或,0.21;95%CI,0.10-0.47;p=0.0001),和Clavien-Dindo主要并发症发生率(OR,0.54;95%CI,0.35-0.84;p=0.006)与对照组相比,在敏感性和亚组分析中结果保持稳定(按研究设计分层,年龄组,使用干预措施,吻合位置,和手术指征)。干预组住院时间明显缩短(加权平均差异(WMD),-1.96;95%CI,-3.21,-0.71;p=0.002)使用随机效应荟萃分析(I2≥50%),特别是上消化道恶性肿瘤手术患者(WMD,-4.94;95%CI,-7.98,-1.90;p=0.001)。
    基于胶原的层状生物材料或纤维蛋白封闭剂在肠吻合上的应用可以显着降低AL及其后遗症的术后发生率。肠吻合的涂层可能是朝着有效和可持续的泄漏预防迈出的一步。为了评估这些发现的有效性和稳健性,需要进一步的临床研究.
    UNASSIGNED: For several decades, scientific efforts have been taken to develop strategies and medical aids for the reduction of anastomotic complications after intestinal surgery. Still, anastomotic leakage (AL) represents a frequently occurring postoperative complication with serious consequences on health, quality of life, and economic aspects. Approaches using collagen and/or fibrin-based sealants to cover intestinal anastomoses have shown promising effects toward leak reduction; however, they have not reached routine use yet. To assess the effects of covering intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative leakage, a systematic review and meta-analysis were conducted.
    UNASSIGNED: PubMed, Web of Science, Cochrane Library, and Scopus (01/01/1964 to 17/01/2022) were searched to identify studies investigating the effects of coating any intestinal anastomoses with collagen and/or fibrin-based sealants on postoperative AL, reoperation rates, Clavien-Dindo major complication, mortality, and hospitalization length. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
    UNASSIGNED: Overall, 15 studies (five randomized controlled trials, three nonrandomized intervention studies, six observational cohort studies) examining 1,387 patients in the intervention group and 2,243 in the control group were included. Using fixed-effects meta-analysis (I 2 < 50%), patients with coated intestinal anastomoses presented significantly lower AL rates (OR = 0.37; 95% CI 0.27-0.52; p < 0.00001), reoperation rates (OR, 0.21; 95% CI, 0.10-0.47; p = 0.0001), and Clavien-Dindo major complication rates (OR, 0.54; 95% CI, 0.35-0.84; p = 0.006) in comparison to controls, with results remaining stable in sensitivity and subgroup analyses (stratified by study design, age group, intervention used, location of anastomoses, and indication for surgery). The length of hospitalization was significantly shorter in the intervention group (weighted mean difference (WMD), -1.96; 95% CI, -3.21, -0.71; p = 0.002) using random-effects meta-analysis (I 2 ≥ 50%), especially for patients with surgery of upper gastrointestinal malignancy (WMD, -4.94; 95% CI, -7.98, -1.90; p = 0.001).
    UNASSIGNED: The application of collagen-based laminar biomaterials or fibrin sealants on intestinal anastomoses can significantly reduce postoperative rates of AL and its sequelae. Coating of intestinal anastomoses could be a step toward effective and sustainable leak prevention. To assess the validity and robustness of these findings, further clinical studies need to be conducted.
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  • 文章类型: Journal Article
    UNASSIGNED:本系统综述的目的是评估纤维蛋白密封剂与缝线在牙周手术中的有效性。
    未经评估:五个电子数据库(PubMed,Scopus,EBSCO,Cochrane和WebofScience)从开始到2021年1月进行了随机对照试验(RCTs),使用以下搜索方程将纤维蛋白密封剂与牙周手术中的缝合线进行比较:(Periodont*OR牙周炎)和(\“纤维蛋白组织粘合剂\”或\“纤维蛋白胶\”或\“纤维蛋白密封剂\”或\“纤维蛋白封闭系统\”或\“纤维蛋白封闭系统\”。纳入研究的质量评估使用修订的工具来评估随机试验中的偏倚风险(RoB2)。使用GRADE工具评估证据水平。
    UNASSIGNED:在筛选的数据库中,共找到240篇出版物作为搜索结果。根据预定的纳入标准,本系统评价中纳入了四个随机对照试验。这些试验发表于1987年至2014年之间。所有RCT都将纤维蛋白密封剂与牙周手术中的缝线进行了比较。样本量包括101名患者。在这项系统评价中,总体偏倚风险在75%的研究中处于高风险,而25%的研究提出了一些担忧。使用GRADE工具评估的证据水平非常低。
    UNASSIGNED:当前的系统评价表明,在牙周实践中使用纤维蛋白密封剂代替缝线的证据水平较低。应进行更多的干预和多中心研究,以支持和确认纳入研究的结果。
    UNASSIGNED: The aim of this systematic review was to assess the effectiveness of fibrin sealant compared to sutures in periodontal surgery.
    UNASSIGNED: Five electronic databases (PubMed, Scopus, EBSCO, Cochrane and Web of Science) were screened from initiation to January 2021 for randomized controlled trials (RCTs) comparing fibrin sealant to sutures in periodontal surgery using this search equation: (Periodont* OR Periodontitis) AND (\"fibrin tissue adhesive\" OR \"fibrin glue\" OR \"fibrin sealant\" OR \"fibrin sealant system\" OR \"fibrin adhesive system\" OR \"fibrin fibronectin sealant system\"). Quality assessment of the included studies was performed using the revised tool to assess risk of bias in randomized trials (RoB 2). The level of evidence was evaluated using the GRADE tool.
    UNASSIGNED: A total of 240 publications were found as search results in the screened databases. Four RCTs were included in this systematic review based on predetermined inclusion criteria. The trials were published between 1987 and 2014. All the RCTs compared fibrin sealant to sutures in periodontal surgery. The sample size included 101 patients. The overall risk of bias in this systematic review was at high risk in 75% of the studies, while 25% of the studies raised some concerns. The level of evidence evaluated using GRADE tool was very low.
    UNASSIGNED: The current systematic review indicates a low level of evidence of the use of fibrin sealant as an alternative to sutures in periodontal practice. More interventional and multicentric studies should be conducted to support and confirm the results of the included studies.
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  • 文章类型: Journal Article
    基于细胞的治疗是一种有希望的治疗方法,可以通过侵入性较小的策略来促进组织愈合。间充质干细胞(MSCs)由于其血管生成而成为潜在的候选者,抗凋亡和免疫调节特性,除了分化成几种专门细胞系的能力。细胞可以通过生物递送系统携带,如纤维蛋白胶,其充当有利于细胞-基质相互作用并允许MSC的局部和旁分泌功能的临时基质。因此,本系统综述的目的是评估纤维蛋白胶联合MSCs在神经再生中的潜力。书目搜索在PubMed/MEDLINE中进行,WebofScience和Embase数据库,使用描述符(“纤维蛋白密封剂”或“纤维蛋白胶”)和“干细胞”和“神经再生”,考虑到2021年之前发表的文章。撰写这篇评论,选择了13项体内研究,根据资格标准。MSCs有利于轴突再生,神经纤维髓鞘再生,以及促进髓鞘纤维数量的增加,髓鞘厚度,轴突的数量和生长因子的表达,在运动功能恢复方面有显著改善。这项系统评价显示了明确的证据,表明纤维蛋白胶与MSCs结合具有再生神经系统病变的潜力。
    Cell-based therapy is a promising treatment to favor tissue healing through less invasive strategies. Mesenchymal stem cells (MSCs) highlighted as potential candidates due to their angiogenic, anti-apoptotic and immunomodulatory properties, in addition to their ability to differentiate into several specialized cell lines. Cells can be carried through a biological delivery system, such as fibrin glue, which acts as a temporary matrix that favors cell-matrix interactions and allows local and paracrine functions of MSCs. Thus, the aim of this systematic review was to evaluate the potential of fibrin glue combined with MSCs in nerve regeneration. The bibliographic search was performed in the PubMed/MEDLINE, Web of Science and Embase databases, using the descriptors (\"fibrin sealant\" OR \"fibrin glue\") AND \"stem cells\" AND \"nerve regeneration\", considering articles published until 2021. To compose this review, 13 in vivo studies were selected, according to the eligibility criteria. MSCs favored axonal regeneration, remyelination of nerve fibers, as well as promoted an increase in the number of myelinated fibers, myelin sheath thickness, number of axons and expression of growth factors, with significant improvement in motor function recovery. This systematic review showed clear evidence that fibrin glue combined with MSCs has the potential to regenerate nervous system lesions.
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  • 文章类型: Journal Article
    Cell therapy strategies using mesenchymal stem cells (MSCs) carried in fibrin glue have shown promising results in regenerative medicine. MSCs are crucial for tissue healing because they have angiogenic, anti-apoptotic and immunomodulatory properties, in addition to the ability to differentiate into several specialized cell lines. Fibrin sealant or fibrin glue is a natural polymer involved in the coagulation process. Fibrin glue provides a temporary structure that favors angiogenesis, extracellular matrix deposition and cell-matrix interactions. Additionally, fibrin glue maintains the local and paracrine functions of MSCs, providing tissue regeneration through less invasive clinical procedures. Thus, the objective of this systematic review was to assess the potential of fibrin glue combined with MSCs in bone or cartilage regeneration. The bibliographic search was performed in the PubMed/MEDLINE, LILACS and Embase databases, using the descriptors (\"fibrin sealant\" OR \"fibrin glue\") AND \"stem cells\" AND \"bone regeneration\", considering articles published until 2021. In this case, 12 preclinical and five clinical studies were selected to compose this review, according to the eligibility criteria. In preclinical studies, fibrin glue loaded with MSCs, alone or associated with bone substitute, significantly favored bone defects regeneration compared to scaffold without cells. Similarly, fibrin glue loaded with MSCs presented considerable potential to regenerate joint cartilage injuries and multiple bone fractures, with significant improvement in clinical parameters and absence of postoperative complications. Therefore, there is clear evidence in the literature that fibrin glue loaded with MSCs, alone or combined with bone substitute, is a promising strategy for treating lesions in bone or cartilaginous tissue.
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  • 文章类型: Journal Article
    骨盆后使用纤维蛋白封闭剂,主动脉旁,腹股沟淋巴结清扫术可以降低淋巴管发病率。这项荟萃分析的目的是评估这一发现是否适用于腋窝淋巴结清扫术。
    纳入了评估纤维蛋白封闭剂减少腋窝淋巴并发症疗效的随机试验。淋巴囊肿,排水输出,手术部位并发症,和住院时间被认为是结果。
    23项随机研究,包括接受乳腺癌腋窝淋巴结清扫术的患者,黑色素瘤,和霍奇金病,包括在内。纤维蛋白封闭剂不影响腋窝淋巴囊肿的发生率,也不影响手术部位的并发症。排水输出,有排水的日子,应用纤维蛋白封闭剂时,住院时间减少(p<0.0001,p<0.005,p=0.008)。
    腋窝夹层后的纤维蛋白封闭剂减少了总腋窝引流输出,排水的持续时间,医院住了。未发现对术后淋巴囊肿发生率和手术部位并发症发生率的影响。
    use of fibrin sealants following pelvic, paraaortic, and inguinal lymphadenectomy may reduce lymphatic morbidity. The aim of this meta-analysis is to evaluate if this finding applies to the axillary lymphadenectomy.
    randomized trials evaluating the efficacy of fibrin sealants in reducing axillary lymphatic complications were included. Lymphocele, drainage output, surgical-site complications, and hospital stay were considered as outcomes.
    twenty-three randomized studies, including patients undergoing axillary lymphadenectomy for breast cancer, melanoma, and Hodgkin\'s disease, were included. Fibrin sealants did not affect axillary lymphocele incidence nor the surgical site complications. Drainage output, days with drainage, and hospital stay were reduced when fibrin sealants were applied (p < 0.0001, p < 0.005, p = 0.008).
    fibrin sealants after axillary dissection reduce the total axillary drainage output, the duration of drainage, and the hospital stay. No effects on the incidence of postoperative lymphocele and surgical site complications rate are found.
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