CN107019551B - Drug-carrying slow-release, flushing and negative pressure suction steel plate - Google Patents

Abstract

The invention discloses a drug-carrying slow-release, flushing and negative pressure suction steel plate, which comprises a steel plate, wherein screw holes are distributed on the steel plate, flushing branch pipes and suction pipes are distributed in the steel plate, the flushing branch pipes are connected to a flushing main pipe, the suction pipes are connected to a suction main pipe, and the flushing main pipe and the suction main pipe penetrate out of the upper surface of the steel plate; the upper surface of the steel plate is provided with liquid leakage holes communicated with the flushing branch pipes, and the upper surface of the steel plate and the side surfaces of the steel plate are provided with suction holes communicated with the flushing branch pipes. The invention effectively solves the problem of controlling the infection of the endophyte, has the functions of medicine slow release, negative pressure suction and flushing, does not need to take out the endophyte when the infection is serious, and can continue to heal the fracture without secondary fixation, thereby saving medical resources and relieving the pain and economic burden of patients.

Description

A drug-loaded sustained release, flushing and negative pressure suction steel plate

Technical field

The invention relates to an orthopedic implant, in particular to a drug-loaded sustained-release, flushing and negative-pressure suction steel plate to solve the infection problem in the application of the implant.

Background technique

The advancement of implants is one of the important components in the development of modern orthopedics. Fracture internal fixation surgery represented by bone plates, screws, and intramedullary nails is currently a routine treatment technology in orthopedic trauma, while artificial joint replacement is an effective method to treat late-stage osteoarthritis, eliminate joint pain, and improve function; both are considered It is hailed as a great breakthrough in the field of orthopedics in the 20th century. According to statistics, more than 800,000 orthopedic implant surgeries of various types are performed in Europe every year. In the United States, more than 200,000 patients undergo joint replacement each year, and as of 2010, more than 4.4 million patients in the United States received internal fixation for fractures. Since 2005, there have been more than 400,000 casualties in traffic accidents in my country every year, and the vast majority of patients have one or more fractures and require internal fixation surgery.

One of the biggest risks with implant application is infection. Studies have shown that in the absence of foreign matter such as implants, 100,000 bacteria per gram of tissue contamination are needed to cause infection. However, in the presence of foreign matter, the number of bacteria required for infection is greatly reduced. Contamination of 100 bacteria per gram of tissue can lead to fatal infection. Studies show that the infection rate after primary hip replacement is 1.6% and the average infection rate after primary knee replacement is 1.3%. The average infection rate after initial fracture internal fixation is greater than 5%, especially the infection rate after initial open fracture internal fixation is as high as 30%. The most worrying and difficult problem for medical staff is internal plant infection. Although effective measures such as strict preoperative disinfection, intraoperative aseptic operation, and application of antibiotics are adopted, the occurrence of infection cannot be avoided. Implant infection is a catastrophic event after orthopedic surgery. Once implant infection occurs, it is difficult for the fracture to heal, which not only causes great pain to the patient, but also wastes a large amount of medical and health resources, causing huge economic losses to the country and individuals. It goes without saying that the control of endophytic infections is of great importance.

Currently, clinical treatment for implant infection usually involves removing the implant, thoroughly debriding it, placing antibiotic beads, etc., and then re-implanting the implant after the infection is controlled; however, the current method will seriously delay the healing time and cause pain to the patient. Comes a heavy financial burden.

Contents of the invention

In view of the problems existing in the above-mentioned prior art, the purpose of the present invention is to provide a drug-loaded sustained-release, flushing and negative-pressure suction steel plate to solve the infection problem during the application of implants, thereby reducing the application risks of implants. Reduce patients' pain and economic burden; mainly used for patients with open fractures.

In order to achieve the above tasks, the present invention adopts the following technical solutions:

A drug-loaded sustained release, flushing and negative pressure suction steel plate, including a steel plate. Screw holes are distributed on the steel plate. A flushing branch pipe and a suction pipe are distributed inside the steel plate. The flushing branch pipe is connected to the main flushing pipe, and the suction pipe is connected to the suction pipe. The suction main pipe, flushing main pipe and suction main pipe all pass through the upper surface of the steel plate;

Leakage holes connected to the flushing branch pipe are distributed on the upper surface of the steel plate, and suction holes connected to the flushing branch pipe are distributed on the upper surface and side of the steel plate.

Further, the drug-loaded sustained-release, flushing and negative-pressure suction steel plate also includes a slow-release flushing bag. The inside of the slow-release flushing bag is divided by two partitions into a first side bag, a second side bag and a second side bag on both sides. The middle bag in the middle is provided with a first one-way valve on both partitions. The first one-way valve only allows fluid to flow into the middle bag from the first side bag or the second side bag; the middle bag is provided with There is an intubation tube matched with the flushing main pipe, and a second one-way valve is provided in the intubation tube.

Further, the suction pipe is distributed at the edge of the steel plate, forming a closed loop; the flushing branch pipe is distributed on both sides of the screw hole.

Further, the steel plate has a rectangular structure, the flushing main pipe is located at the center of the upper surface of the steel plate, the flushing branch pipes are distributed along the length direction of the steel plate on both sides of the flushing main pipe, and are finally connected through the first connecting pipe. to the flush main.

Further, the described suction tube includes a first suction tube and a second suction tube, wherein the first suction tube is distributed at the edge of the steel plate in the length direction, the second suction tube is distributed at the edge of the steel plate in the width direction, and the first suction tube is distributed at the edge of the steel plate in the width direction. , the ends of the second suction pipe are connected, and both pass through the side or end face of the steel plate.

Further, the suction holes include first suction holes and second suction holes, where the first suction holes are distributed on the edge of the upper surface of the steel plate, and the second suction holes are distributed on the side and end surfaces of the steel plate, The first suction hole and the second suction hole are both connected to the first suction pipe or the second suction pipe.

Furthermore, the first side bag, the second side bag and the middle bag have the same volume and are all air bags.

Compared with the existing technology, the present invention has the following technical features:

1. The present invention can realize the sustained release function of drugs, and can make the effective concentration of the drug locally reach the wound surface without the need for systemic application of antibiotics, thereby reducing the dosage of the drug and improving the drug use effect; the drug in the present invention can be sustained-released in batches , can have better therapeutic effect, and the drug release process is non-invasive and does not require incision;

2. The drug release and negative pressure flushing processes in the present invention are very simple to operate, which can effectively reduce the number of surgeries, thereby reducing surgical risks, reducing the pain and economic burden of patients, and improving the work efficiency of medical staff;

3. In the present invention, negative pressure suction can be used to aspirate drainage fluid for qualitative culture to identify bacteria, so that sensitive antibiotics can be used to flush the wound surface to achieve better therapeutic effects; in addition, negative pressure suction can be used to suction Stretch stimulation promotes the formation of fresh granulation tissue at the micropores on the surface of the steel plate, which is beneficial to the healing of deep tissues;

4. The present invention solves the problem of implant infection control. It does not need to take out the implant when the infection is serious. The fracture site can continue to heal without secondary fixation; and the steel plate can be taken out after the fracture has healed to a certain extent and then thoroughly cleaned. Innovative, this medical device effectively saves medical resources and has good transformation prospects.

Description of the drawings

Figure 1 is a schematic top view of the overall structure of the present invention;

Figure 2 is a schematic side structural view of Figure 1 (view in direction A of Figure 1);

Figure 3 is a schematic diagram of the end face structure of Figure 1 (view in direction B of Figure 1);

Figure 4 is a schematic cross-sectional view along C-C in Figure 1;

Figure 5 is a schematic structural diagram of the matching part between the sustained-release irrigation bag and the steel plate;

The numbers in the figure represent: 1—steel plate, 2—main flushing pipe, 3—first connecting pipe, 4—flushing branch pipe, 5—main suction pipe, 6—second connecting pipe, 7—leak hole, 8—screw Hole, 9—suction tube, 91—first suction tube, 92—second suction tube, 10—suction hole, 101—first suction hole, 102—second suction hole, 11—intubation, 12— Slow-release irrigation bag, 121—middle bag, 122—first side bag, 123—second side bag, 13—first one-way valve.

Detailed ways

Complying with the above technical solution, as shown in Figures 1 to 5, a drug-loaded sustained release, flushing and negative pressure suction steel plate of the present invention includes a steel plate 1 with screw holes 8 distributed on it; the steel plate 1 serves as The implant is implanted into the patient's body, the bone screw is screwed in through the screw hole 8, and the broken ends of the fracture site are fixed together using the steel plate 1.

There are flushing branch pipes 4 and suction pipes 9 distributed inside the steel plate 1. The flushing branch pipes 4 are connected to the flushing main pipe 2, and the suction pipe 9 is connected to the suction main pipe 5. The flushing main pipe 2 and the suction main pipe 5 both penetrate the upper surface of the steel plate 1; Leakage holes 7 connected to the flushing branch pipe 4 are distributed on the upper surface of the steel plate 1, and suction holes 10 connected to the flushing branch pipe 4 are distributed on the upper surface of the steel plate 1 and on the side of the steel plate 1.

In this solution, the leakage hole 7 has multiple functions. For example, antibiotic particles can be preset in the leakage hole 7. When the wound needs to be anti-inflammatory, the medicine can be pushed to the wound through gas or liquid to achieve local anti-inflammation; and The leakage hole 7 can also be used as a liquid outlet hole during wound cleaning. The flushing main pipe 2 is used to connect to the flushing system, and the wound surface is flushed when necessary, and the suction main pipe 5 is used to suck out the flushing fluid to form a circulation system. The suction holes 10 are distributed on the upper surface and side of the steel plate 1. The suction holes 10 can be used to extract fluid from the wound, and can also be used in conjunction with the flushing main pipe 2 to perform cyclic flushing of the wound surface.

In order to better cooperate with the above-mentioned drug release and flushing functions, the drug-loaded sustained release, flushing and negative pressure suction steel plate in this solution also includes a slow-release flushing bag 12. The inside of the slow-release flushing bag 12 is divided into two parts by two partitions. The first side bag 122, the second side bag 123 and the middle bag 121 in the middle are provided with first one-way valves 13 on both partitions. The first one-way valve 13 only allows fluid to flow from the first side bag. 122 or the second side bag 123 flows into the middle bag 121; the middle bag 121 is provided with an intubation tube 11 that matches the flushing main pipe 2, and a second one-way valve is provided in the intubation tube 11.

The slow-release flushing bag 12 and the steel plate 1 have a detachable structure, and can be plugged and unplugged with the flushing main pipe 2 through the intubation tube 11 . The sustained-release flushing bag 12 is a soft bag, for example, a rubber air bag. The purpose of setting up three capsules is to push the medicine at different times after the steel plate 1 is inserted, so as to facilitate the sustained release of the medicine in batches. The volumes (capacities) of the three capsules can be the same or different. When the volume is the same, a certain amount of medicine can be released to the wound each time. The above-mentioned fluid refers to liquid or gas.

In the embodiment given in Figure 1, a preferred structure of the steel plate 1 is shown. Among them: the suction tube 9 is distributed at the edge of the steel plate 1, forming a closed loop; the suction tube 9 at the edge can better realize the suction and recovery of accumulated fluid and flushing fluid. The flushing branch pipes 4 are distributed on both sides of the screw hole 8 .

Furthermore, the steel plate 1 has a rectangular structure, the flushing main pipe 2 is located at the center of the upper surface of the steel plate 1, the flushing branch pipes 4 are distributed along the length direction of the steel plate 1 on both sides of the flushing main pipe 2, and finally pass through the first The guiding tube 3 is connected to the flushing main pipe 2; the suction tube 9 is finally connected to the suction main pipe 5 through the second guiding tube 6. In order to facilitate the formation of a circuit when irrigating the wound surface, in this solution, two suction main pipes 5 are symmetrically arranged on both sides of the irrigation main pipe 2.

As shown in Figures 1 to 4, the suction tube 9 includes a first suction tube 91 and a second suction tube 92. The first suction tube 91 is distributed at the edge of the steel plate 1 in the length direction, and the second suction tube 92 is distributed at the edge of the steel plate 1. At the edge in the width direction, the ends of the first suction tube 91 and the second suction tube 92 are connected, and both penetrate the side or end surface of the steel plate 1 . The suction holes 10 include first suction holes 101 and second suction holes 102 , where the first suction holes 101 are distributed on the edge of the upper surface of the steel plate 1 , and the second suction holes 102 are distributed on the side and end surfaces of the steel plate 1 , the first suction hole 101 and the second suction hole 102 are both connected to the first suction tube 91 or the second suction tube 92; taking the first suction hole 101 as an example, the one located on one side of the upper surface in the length direction The first suction hole 101 is connected to the first suction pipe 91 , and the first suction hole 101 located on one side in the width direction is connected to the second suction pipe 92 .

When this device is in use, a predetermined concentration of antibiotic solution can be stored in the main flushing pipe 2 and the flushing branch pipe 4 in advance. After the fracture fixation wound is completely closed, the entire device is inside the tissue, and the sustained-release flushing bag 12 is pressed three times after the operation. Press the middle bag 121 first, and then press the first side bag 122 and the second side bag 123 twice. When the volumes of the three bags are the same, the three extrusion processes can squeeze the antibiotic solution to the wound surface with equal volume. middle. This method does not require systemic application of antibiotics, and the effective concentration of the drug can be achieved locally, and the drug can be sustained and released in batches.

If there are signs of infection during the fracture healing period, a 2cm minimally invasive incision can be made, the slow-release irrigation bag 12 is removed, the external negative pressure drainage and irrigation system is connected to the irrigation main pipe 2 and the suction main pipe 5, and the necrotic tissue near the implant, Pus, tissue exudate, etc. are drained to the outside of the body. Physiological saline, disinfectant, etc. can be poured into the flushing port through the flushing port. The suction main pipe 5 then drains the flushing fluid to the outside of the body again, thereby forming a circulatory system.

This device is simple to operate and can reduce the number of operations. In the first operation, a drug-loaded sustained-release, flushing and negative pressure suction steel plate was implanted. After the infection was controlled and the fracture healed, the steel plate 1 was removed in the second operation. A total of 2 operations were performed, and an implant was implanted once. The routine clinical treatment process for implant infection: ① Remove the implant, implant antibiotic bone cement, and temporarily fix the external fixator (first operation); ② When the infection is well controlled, remove the antibiotic bone cement and remove the external fixator. Implant the internal fixation again (second surgery); ③ Because the patient may develop chronic osteomyelitis, the internal fixation needs to be removed again after the fracture heals. A total of 3 surgeries were performed, including 2 implant implants, 1 bone cement implant, and 1 exoskeleton fixation.

Claims (4)

1. A drug-loaded sustained release, flushing and negative pressure suction steel plate, including a steel plate (1). Screw holes (8) are distributed on the steel plate (1). It is characterized in that the inside of the steel plate (1) There are flushing branch pipes (4) and suction pipes (9) distributed, among which the flushing branch pipe (4) is connected to the flushing main pipe (2), the suction pipe (9) is connected to the suction main pipe (5), the flushing main pipe (2), and the suction main pipe (2). The main pipes (5) all penetrate the upper surface of the steel plate (1); The upper surface of the steel plate (1) is distributed with leakage holes (7) connected to the flushing pipe (4), and the upper surface of the steel plate (1) and the side of the steel plate (1) are evenly distributed with the suction pipes. (9) Connected suction holes (10); the suction pipe (9) includes a first suction pipe (91) and a second suction pipe (92), wherein the first suction pipe (91) is distributed on the steel plate (1 ) at the edge in the length direction, the second suction tube (92) is distributed at the edge in the width direction of the steel plate (1), the ends of the first suction tube (91) and the second suction tube (92) are connected, and both pass through The side or end face of the steel plate (1); Antibiotic particles are provided in the leakage hole (7); The drug-loaded slow-release, flushing and negative-pressure suction steel plate also includes a slow-release flushing bag (12). The inside of the slow-release flushing bag (12) is divided by two partitions into first side bags (122) on both sides. , the second side bag (123) and the middle bag (121) in the middle, in which a first one-way valve (13) is provided on both partitions. The first one-way valve (13) only allows fluid to flow from the first side. The bladder (122) or the second side bladder (123) flows into the middle bladder (121); the middle bladder (121) is provided with an intubation tube (11) that cooperates with the flushing main pipe (2). A second one-way valve is provided in (11); The first side bag (122), the second side bag (123) and the middle bag (121) have the same volume. 2. The drug-loaded sustained release, flushing and negative pressure suction steel plate according to claim 1, characterized in that the suction tube (9) is distributed at the edge of the steel plate (1) and forms a closed loop; The flushing pipes (4) are distributed on both sides of the screw hole (8). 3. The drug-loaded sustained release, flushing and negative pressure suction steel plate according to claim 1, characterized in that the steel plate (1) has a rectangular structure, and the flushing main pipe (2) is located on the steel plate (1) At the center of the upper surface, the flushing branch pipes (4) are distributed along the length of the steel plate (1) on both sides of the flushing main pipe (2), and are finally connected to the flushing main pipe (3) through the first connecting pipe (3). 2). 4. The drug-loaded sustained release, flushing and negative pressure suction steel plate according to claim 1, characterized in that the suction hole (10) includes a first suction hole (101) and a second suction hole ( 102), in which the first suction holes (101) are distributed at the edge of the upper surface of the steel plate (1), and the second suction holes (102) are distributed on the side and end faces of the steel plate (1). The first suction holes (101) ) and the second suction hole (102) are both connected to the first suction pipe (91) or the second suction pipe (92).