Lucero Manzano, Andrea M. (2018) Efectos de la contaminación y posterior resterilización en la performance de implantes ortopédicos. / Effects of contamination and subsequent resterilization in the performance of orthopedic implants. Maestría en Ingeniería, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
En Argentina es usual la práctica de reprocesamiento de implantes, tales como tornillos y placas que no fueron empleados durante una cirugía traumatológica, para poder utilizarlos durante intervenciones quirúrgicas subsiguientes. Dicho reprocesamiento incluye lavado y esterilización de los implantes para dejarlos en condiciones asépticas para un nuevo procedimiento. De acuerdo a la legislación nacional e internacional investigada, la mayoría de los organismos regulatorios no tiene una postura clara respecto a esta práctica. Sin embargo, existe evidencia que sugiere que la resterilización de estos implantes resulta en una degradación de la performance de los mismos, tanto desde el punto de vista de las propiedades superficiales y mecánicas como biológicas. Por todo esto, se estableció como objetivo del presente trabajo la caracterización de tornillos corticales de fabricación nacional sometidos a repetidos procesos de lavado y esterilización, con el fin de analizar la implicancia que estas prácticas tienen en el desempeño posterior de los mismos. A tal fin, se realizaron ensayos de tracción y de fatiga sobre los tornillos, para los cuales se dise~naron dispositivos complementarios de agarre para ser utilizados junto a las mordazas de una máquina de ensayos servohidráulica. Asimismo, se efectuó un análisis de la superficie mediante la técnica de microscopía electrónica de barrido y se complementó con ensayos de crecimiento bacterial. No se hallaron diferencias significativas en los resultados de los ensayos mecánicos efectuados al evaluar tornillos con distinta cantidad de reprocesamientos. Sin embargo, la observación de la superficie sugiere la formación de partículas de óxido cuyo número por unidad de área y tamaño se incrementa con el número de veces que se repite el proceso. Se verificó crecimiento bacterial en muestras con distinta cantidad de reprocesamientos. Sin embargo, no se observó este fenómeno en muestras de tornillos importados con un valor de rugosidad menor. Es posible que la rugosidad asociada al proceso de fabricación enmascare un posible efecto de los ciclos repetidos de reprocesamiento. Como resultados colaterales de este trabajo se puede inferir a partir de la caracterización inicial de las muestras que el proceso de producción de tornillos no es óptimo.
Resumen en inglés
In Argentina, repeated reprocessing of implants that were not used during trauma surgery, such as screws and plates, is currently routinely practiced. The activities of reprocessing include cleaning and sterilization of implants in order to leave them in aseptic conditions for a new procedure. According to the national and international legislation available, most regulatory agencies do not have a clear position regarding this practice. However, there is evidence that suggests that resterilization of these implants results in a degradation of their performance, taking into account the surface, mechanical and biological properties. Therefore, the purpose of this work is to characterize cortical screws of local manufacture subjected to repeated cleaning and sterilization processes, in order to analyze the implication that these practices have in the subsequent performance of these devices. Tensile and fatigue tests were carried out on the screws, for which complementary gripping devices were designed to be used together with the jaws of a servohydraulic testing machine. In addition, a surface analysis was carried out using scanning electron microscopy and complemented with bacterial growth assays. No signicant differences were found in the results of the mechanical tests carried out when evaluating screws with different amounts of reprocessing. However, surface characterization suggests the formation of oxide particles whose number per unit area and size increases with the number of times the process is repeated. Bacterial growth was veried in samples with different amount of reprocessing. However, this phenomenon was not observed in samples of imported screws with a lower roughness value. It is possible that the roughness associated with the manufacturing process masks a possible effect of the repeated cycles of reprocessing. As collateral results of this work, it can be inferred from the initial characterization of the samples that the screw production process is not optimal.
| Tipo de objeto: | Tesis (Maestría en Ingeniería) |
|---|---|
| Palabras Clave: | Screws; Tornillos; Sterilization; Esterilización; Implants; Implantaciones [Stainless steel; Acero inoxidable; Reprocessing; Reprocesamiento; Bacterial resistance; Resistencia bacteriana] |
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| Materias: | Física > Física de materiales |
| Divisiones: | Gcia. de área de Investigación y aplicaciones no nucleares > Gcia. de Física > Ciencias de materiales > Física de metales |
| Código ID: | 789 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 18 Jun 2019 12:27 |
| Última Modificación: | 18 Jun 2019 12:27 |
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