The Experimental Study Of The Revascularized Sequester To Repair Bone Defect Of Osteomyelitis

一ObjectiveThe segmental bone defect often comes from debridement of necrosis cortical bone in post-trauma osteomyelitis.It is very difficult to repair the infect bone defect.We tried to create an animal model of post-trauma osteomyelitis according to clinical pathogenesy.Based on the animal model,the dead bone was prepared to be an partial decalcified bone matrix(DBM).Then we tried to revascularize the DBM to repair the infected tibia defect.二MethodsThe first part:Founding of animal model of necrosis cortical bone in post-trauma osteomyelitis with soft tissue defect.Staphylococcus aureus and foreign body were inoculated into the rat tibia medullary space through the bone defect.The bone block from the tibia defect was replanted onto the defect and was revealed by outpouching the soft tissue.Pathohistology and radiology were used to evaluated the osteomyelitis and bone necrosis.The second part:Preparation of decalcified bone matrix of necrosis cortical bone from the rat infect tibia and determination of the physico-chemical and vitodynamics.property.According to reforming Urist method,the partial decalcified bone matrix (DBM) was obtained from necrosis cortical bone of osteomyelitis by decalcification and defat.The porosity and calcium contents and deformation-lord curve were evaluated by scanning electron microscope and automatic biochemistry analyzer and vitodynamics machine created with of S.aureus and foreign body,while the bone was exposed in the air.It was evaluated with X-ray and pathology.After decalcified and defatted,the necrosis cortical bone was scanned by scanning electric-microscopy,measured the calcification by automatic biochemical machine,measured the biomechanics characteristic by biomechanics machine.The third part: The experimental study of autologous revascularized partial decalcified bone matrix to repair the osteomyelitis bone defect.The sterilized partial decalcified bone matrix was embedded into the superficial epigastric artery muscle flap to revascularize.Combined with the muscle flap vessel pedicle,it was transferred into the infected tibia defect.the revascularization and bone defect reparation,were observed by radiology and pathohistology 三ResultThe test tibia revealed feature of osteomyelitis.And the replanted bone was necrosis. The animal model of necrosis cortical bone in post-trauma osteomyelitis with soft tissue defect was founded.After decalcification and defat,the partial decalcification bone matrix was obtained from the necrosis cortical bone.Its calcium contents is 92.17±0.54 mg/g and decalcification rate 38.1%.Two kinds of cellular structure communicating each other were observed through scanning electron microscope with 7～15μm and0.1～0.4μm in diameters. Deformation and lord is functional relation.the deformation raised with the increased lord.Deformation-load curve was similar to the fresh cortical bone curve.Four weeks later, the necrosis cortical bone matrix embedded in the superficial epigastric artery muscle flap were revascularized and decalcified in the infected tibia defect during the later time.四ConclusionThe animal model of necrosis cortical bone in post-trauma osteomyelitis with soft tissue defect was successfully created in our method.After decalcification and defat,the necrosis cortical bone revealed porous structure and vitodynamics intensity.The necrosis cortical bone matrix embedded in the muscle flap was able to revascularize and repair the infected bone defect.