IMPLANTATY in surgery

From Big Medical Encyclopedia

IMPLANTS in surgery [lat. in (im) prefix - in, inside + plantatus replaced from plantare to put, replace] — devices from any materials which are entered into a human body for temporary or constant performance of various functions. From a transplant And. differs in what always consists of inorganic materials. The term «implant» appeared from 60th 20 century in connection with development of surgery and the equipment.

Depending on structure, terms of stay in an organism, tactics, technology of operation, postoperative period and other indicators And. distinguish as follows:

1) on structure and a design: simple — from one or several materials; difficult — consisting of diverse materials and several constructive nodes, each of which carries out certain tasks and at damage ceases to function;

2) on duration of functioning — temporary, constant;

3) on extent of immersion in an organism — completely implanted, partially implanted.

Surgical glue, a suture material, stomatol, devices and dentures, surgical films most of authors to And. does not carry.

And. apply almost in all fields of medicine: orthopedics, heart surgery, vascular surgery, ophthalmology, endocrinology, neurology, pulmonology, general surgery, cosmetic surgery, otorhinolaryngology, stomatology, neurosurgery.

Indications: substitution or completion of fabrics or the basic device, stimulation of functions of various bodies — a bladder, heart (see. Cardiostimulation ), full or partial substitution of bodies — valves of heart (see. Prosthetics of valves of heart ), vascular prostheses (see. Blood vessels ), joints (see. Endoprosthesis replacement ), etc.

Simple And. serve for performance of any certain function: mechanical, optical, electric, etc.

Difficult And. have mobile parts and perform difficult functions — artificial joints, artificial valves of heart, pacemakers, etc.

Examples And., partially immersed in an organism, there can be orthopedic spokes for fixing of changes, endocardial electrodes for cardiostimulation; in these cases And. are temporary. In other cases And. completely plunges into an organism and can function up to 10 years and more (e.g., artificial valves of heart).

After introduction And. there is a peculiar system of interaction: an organism — the implant, at the same time reaction of an organism (the general and local) that is more difficult, than more difficult carried out And. function and its design. Success of operation eventually depends on the nature of local (fabric) and general reaction of an organism. At the same time And., being in such difficult biol, system as the organism, especially for a long time, is exposed in various degree mechanical, physical., to chemical influence, to-rogo can result from breakdown of separate nodes of difficult implants, and they should be replaced.

In each medical discipline are available as the private questions concerning technology of operation, indications and contraindications, features of functioning, and the general, concerning features of reaction of fabrics to the implanted devices, features of engraftment And., changes of materials in use. It is necessary to consider also complexity of an operative measure, various features of the used material etc. There are separate opinions on a possibility of allocation of the special section of modern medicine — implantology.

Selection of materials, designing and manufacturing techniques And., bench tests are carried out jointly by engineers and medical specialists taking into account the latest developments of science and technology.

See also Alloplasty .

Bibliography: Williams D. and Rouf River. Implants in surgery, the lane with English, M., 1978.

R. P. Zubarev, E. V. Kolpakov