A COMBINED MORPHOINDUCTIVE ALLOTRANSPLANT FOR PLASTY OF CRANIAL DEFECTS IN CHILDREN

B.M. Topor, V.L. Petraki

Research Institute of Medical Care Rendered to Children with Developmental Defects of a Craniofacial Area and Congenital Diseases of the Nervous System

Efficacy of plasty of cranial defects is strongly dependent on physical-biological characteristics of a transplant. There are two very important things: on the one hand, it is immunologic compatibility of a transplant and the body of a recipient and on the other – possibility to ensure not only a mechanical closure of a defect, but also bone regeneration around it. The last circumstance is of peculiar importance if to take into account dynamic changes of dimensions of a child’s growing skull.

This problem can be solved by a method of making and application of a combined allotransplant called Osteomatrix-Forte. It consists of a demineralized bone trasplant and osteoinductive bone mass. The latter is made of bone matrix of adult donors and brefometrix, i.e. a bone, cartilaginous and connective tissue of embryos. It possesses higher osteoinductive properties, good adhesion and takes a necessary shape quite easily being friable and hygroscopic at the same time. The bone transplant is made of a formalinized bone of a donor’s skull fornix and is shaped in accordance with a form of a recipient’s defect. A network of intersecting longitudinal canals and through perforations is provided. It is followed by partial dosed demineralization of the transplant resulting in its elasticity with simultaneous preservation of rigidity of its framework. After this the transplant is saturated with embryonal supernatate. The bone mass is placed into lumens of canals of the bone transplant during operations.

Experimental study of the transplant properties was carried out on rabbits and rats. As for clinical conditions the combined allotransplant was used for plasty of a cranial defect in 50 children aged 12-15. The analysis of operations showed low toxicity of the transplant and its good compatibility with the body of a recipient. The transplant ensures hermetic sealing of the skull, promotes early and active bone regeneration not only along the edges but also its along whole length. There were no complications connected with changing dimensions and form of a child’ growing skull.